Presentation
Wrist swelling.
Patient Data
An oblique linear hypoechoic subcutaneous area is noted with central wavy linear echogenic structure reaching the skin ulcer with parallel rail-like morphology, in keeping with suture granuloma.
The site of ultrasound examination refers to the skin ulcer that is adjacent to the skin mark of old surgical wound.
Case Discussion
The patient had a history of wrist surgery since 6 years for penetrating wrist trauma. The echogenic wavy linear structure mostly represents the retained suture material. The suture-induced inflammatory changes are a suture granuloma. The suture material often has parallel hyperechoic "rail-like" morphology. It can present many years after the surgical procedure. Treatment is by excision of the granuloma and the retained suture.
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