Foreign Bodies

Fig. 18.1

Glass fragment. Sonography shows a hyperechoic fragment with posterior reverberation (arrow) in the subcutaneous tissue. Posterior reverberation artifacts are characteristic of glass fragments

Fig. 18.2

Metal sliver. Radiography reveals a small sliver near the second metacarpal head. The intense radiopacity of the object is typical of metal (a). On sonography, the sliver appears hyperechoic (arrows) (b) with posterior reverberation and a halo of granulation tissue, which appears hypoechoic and hypervascularized (c, d)

Table 18.1

Ultrasonographic appearance of the foreign bodies most commonly found in the hand and wrist

Glass fragments	Hyperechoic objects with posterior reverberation artifacts
Metal fragments	Hyperechoic objects with posterior attenuation
Wooden splinters, thorns, cactus spines	Hyperechoic objects with no reverberation or posterior artifacts

Fig. 18.3

Wood splinter. The sonographic examination reveals a hyperechogenic object (arrows) with no attenuation or posterior reverberation. Like many splinters, this one is surrounded by hypoechoic granulation tissue

While radiography can easily identify the presence of a radiopaque foreign bodies [1, 2], sonography can also reveal those that are radiolucent (cactus spines, thorns, wood splinters, and fragments of nonradiopaque glass) [1, 2, 4, 5].

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