Foreign Body

A 40-year-old man presented to the emergency department with moderate to severe pain over the left lateral wrist. Earlier in the day, an iron rod had accidentally struck his wrist. The patient’s history included chronic obstructive pulmonary disease, hypertension, and social anxiety disorder. Drs Rahul Gupta and Seema Gupta of Florala, Ala, write that the area over the distal radius was significantly tender. The distal pulse and the overlying skin were normal; no warmth or swelling was noted. A loss of touch and pain sensations extended proximally from the left thumb to the lateral wrist.

A roentgenogram disclosed a needle-like foreign body (A). On further questioning, the patient revealed that constant mild local pain and numbness in the left thumb began after a wrist laceration was sutured 2 years earlier. An ultrasonogram (B) revealed the atypical shadow of a foreign body. Surgical exploration disclosed a 1.5-cm curved surgical suture needle embedded in the periosteum of the distal lateral radius. The needle was removed. Although the moderate to severe pain the patient initially complained of abated, the numbness and mild local pain did not resolve.