Using Transillumination to Diagnose a Foreign Body

By Amanda Anderson, DO; Jaden Miller | on March 5, 2024 | 1 Comment

Features

FIGURE 3: MRI of foot without identifiable foreign

body secondary to motion artifact. (Click to enlarge.)

Teaching Points

Transillumination can be used in soft tissue areas to further evaluate foreign bodies. Many foreign bodies are not radiopaque for X-ray imaging, and this was nearly missed on MRI due to the small nature.
Early closure is a pitfall that was thankfully avoided by listening to the parents.
Ultrasound could also be an imaging modality, if the patient would tolerate this.

Dr. Anderson is a board-certified emergency physician at a community hospital in St. Cloud, MN.

Mr. Miller is a first-year medical student at the University of Minnesota-Duluth.

References

Campbell EA, Wilbert CD. (2023). Foreign body imaging. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Accessed February 27, 2024.
Chen K-C, Lin AC-M., Chong CF, et al (). An overview of point-of-care ultrasound for soft tissue musculoskeletal applications in the emergency department. J Intens Care. 2016;4:55.
Halaas GW. (). Management of foreign bodies in the skin. Am Fam Physician.2007;76(5):683-8.
Pattamapaspong N, Srisuwan T, Sivasomboon C, et al. Accuracy of radiography, computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot. La Radiologia Medica. 2013;118, 303-10.
Wright E, Somwaru B. POCUS and soft tissue foreign bodies. REBELEM website. Published January, 2021. Accessed February 27, 2024.

Topics: Case Reports Clinical Imaging & Ultrasound

March 10, 2024
Will Grad Reply

Two of my most satisfying cases in my over 30 yrs of EM practice were finding and removing foreign bodies in the feet of 2 adult men who both had been suffering for over a year with pain that could not be explained. Both had been to multiple other physician specialists who had failed to diagnosis the problem. I made the diagnosis in each case relatively quickly using bedside ultrasound. Interestingly, in both cases the patients could not remember the traumatic events which had led to the foreign bodies becoming imbedded. (One wood, one a small pebble.)