Nexplanon contraceptive implant

Case contributed by Dr Ashesh Ishwarlal Ranchod

Presentation

Patient presented for removal and re-insertion of a Nexplanon contraceptive implant. The implant could not be palpated and the patient was referred for radiological localization.

Patient Data

Age: 35 years
Gender: Female

Left Humerus (soft tissue exposures)

X-ray

The left humeral soft tissue views confirm the elusive radiopaque Nexplanon implant within the posteromedial subcutaneous tissues approximately 10 cm superior to the left elbow. 

It also appears extramuscular, i.e. accessible for removal.

Case Discussion

Implanon and Nexplanon are 2 types of dermal contraceptive implants. The original Implanon has been discontinued in some countries and replaced by the newer Nexplanon (or Nexplanon NXT) due to insertion errors and consequent complications with the former implant. Nexplanon is made of ethylene vinyl acetate copolymer (a non-absorbable plastic). 

Implanon is radiolucent and cannot be identified by X-ray or CT, only by US or MRI. The newer Nexplanon has a small volume of barium sulphate inserted into the rod to make it radio-opaque and so can be identified by 4 modalities: X-ray, US, CT and MRI.

They are usually implanted within the non-dominant arm, just above the elbow, within the superficial extramuscular soft tissue and can often be palpated to assess correct placement and to assist timely and easy removal.

They are usually effective for approximately 3 years.

Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.

 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.