Presentation
History of foot diffuse swelling 2 months back. Presented with a residual small nodule on the medial side of the mid foot.
Patient Data
There is a linear echogenic focus (7 mm length) at the site of the nodule pointed by the patient. It shows two echogenic lines with central lucency and shows tapering at one end. It is a foreign body - a thorn fragment. There is a hypoechoic soft tissue nodule ( about 11 x 8 x 6 mm ) around the foreign body. It is a foreign body granuloma. The foreign body is outside the nearby tibialis posterior tendon. There is no tenosynovitis.
The intraoperative photo shows the tip of the foreign body as a black dot. 2nd photo shows a retrieved foreign body - a thorn fragment.
Case Discussion
The case shows a foreign body granuloma due to a thorn fragment. The patient did not collect thorn injury.
Intraoperative and foreign body specimen photos: courtesy operating surgeon Dr. Pinkesh V. Patel.