Multidetector CT for thorn (wooden) foreign bodies of the knee
Tóm tắt
Thorn (wooden) foreign bodies of the knee present a challenge in their diagnosis. Partly because of inaccurate history and sometimes a long duration of symptoms, radiographs are negative and MRI may show synovitis without a specific pathology. We report a case of a 16-year-old male patient with a date palm thorn foreign body, which caused septic arthritis. He underwent two open surgeries. Both failed to detect the loose body. An MRI of the knee showed a high signal in the posterolateral compartment; however, the pathology could not be confirmed except by 64 Multidetector CT (MDCT) that clearly identified the thorn and its location. Arthroscopic removal and synovectomy were done by a 4-portal technique. The patient went on to complete recovery. Multidetector CT has proven very useful in identifying wooden foreign bodies, their size and location.
Tài liệu tham khảo
Bauer AR Jr, Yutani D (1983) Computed tomographic localization of wooden foreign bodies in children’s extremities. Arch Surg 118:1084–1086
Bray PW, Mahoney JL, Campbell JP (1995) Sensitivity and specificity of ultrasound in diagnosis of foreign bodies in the hand. J Hand Surg 20:661–666
Tung C-H, Chen Y-H, Howard HC, Lan T-Y, Hsieh D-Y, Lan J-L (2007) Diagnosis of plant-thorn synovitis by high-resolution ultrasonography: a case report and literature review. Clin Rheumatol 26:849–851
Kornreich L, Katz K, Horev G, Zeharia A, Mukamel M (1998) Preoperative localization of a foreign body by magnetic resonance. Eu J Radiol 26:309–311
Mizel MS, Steinmetz ND, Trepman E (1994) Detection of wooden foreign bodies in muscle tissue: experimental comparison of computed tomography, magnetic resonance imaging and ultrasonography. Foot Ankle Int 15:437–443
Ramanathan EBS, Luiz CP (1990) Date palm thorn synovitis. J Bone Joint Surg (Br) 72(B):512–513
Taskerian E, Toros T (2002) Chronic synovitis caused by a date palm thorn: an unusual clinical picture. Arthroscopy 18:E7