Charm needles (susuk) over the chest wall

Case contributed by Weiling Tan

Patient Data

Gender: Female

Chest x-ray

X-ray

Multiple charm needles projected over chest wall.

Case Discussion

Susuk are a form of charm needles inserted subcutaneously in various regions such as the orofacial region, breasts, chest, pubic region, and the limbs as a form of "black magic". This is largely practiced in South East Asian countries of Singapore, Indonesia, Thailand, and Brunei. 

These linear metallic objects are about 0.5-1mm in diameter, and about 5-10mm in length. They are made of various radiopaque materials such as gold or steel, or even diamonds, fruit or flowers, which would make it less detectable on radiological imaging. 

These objects are believed to bring the wearer luck, wealth, beauty, and other benefits. However, the insertion of these susuks need to be done in secret or it risks losing its effectiveness. Similarly, when the susuk is known to exist by anyone else but the wearer, it would too lose its effectiveness. This is also why patients may deny having undergone any form of procedure that may have resulted in the incidental finding of a "foreign body". 

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