Presentation
History of a wooden splinter-prick one month back while working in the field. Pain and swelling in the palmar aspect of the hand, swelling since then with pus discharging from the puncture.
Patient Data
No radio-dense foreign body could be detected on the hand radiographs, however prominent soft tissue along the palmar aspect.
There is a hand palmar aspect subcutaneous well defined regular shaped longitudinal lesion is seen measuring about 6.8 cm long and is obliquely oriented parallel to thenar eminence of low signal intensity at all pulse sequences surrounded by mild localized fluid collection along its most course
No deep extension along deep palmar spaces
No definite tendon rupture or tenosynovitis seen
No definite masses could be detected along the dorsal aspects of hand
There is no definite bone fracture noted along the meta carpal or phalangeal bones.
No evidence of marrow edema or infiltrative processes in the bones included in the study
No significant joint effusion along the MCP and IP joint compartments
Case Discussion
Foreign bodies in the hand are common in manual workers who work with bare hands. The frequent foreign bodies include thorns, wooden splinters, and nails or glass pieces. Radiographs can detect metallic foreign bodies.
High-resolution ultrasound as well as MRI images can localize the radiolucent foreign body and can detect associated complications like abscess formation and the spread of infection.