J Korean Soc Radiol.  2017 Jun;76(6):434-437. 10.3348/jksr.2017.76.6.434.

An Unrecognized Foreign Body Retained in the Calcaneus: A Case Report

• Lee RW
• Choi SJ
• Hwang JK
• Ahn JH
• Kang CH
• Shin DR

• KMID: 2379327
• DOI: http://doi.org/10.3348/jksr.2017.76.6.434

Abstract

We describe a case of an unrecognized foreign body retained in the calcaneus. The patient denied any history of trauma. The skin overlying the calcaneus was intact with no local signs of inflammation. The retained foreign body was not observed on the radiograph of the calcaneus. Magnetic Resonance Imaging showed a tubular low signal intensity lesion in the calcaneal body, surrounded by strongly enhanced soft tissue and bone marrow edema caused by a foreign body reaction. A foreign body retained in the calcaneus was suspected on the basis of these findings. Surgical exploration and curettage was performed, and a rod shaped wooden fragment was found.

MeSH Terms

Bone Marrow
Calcaneus*
Curettage
Edema
Foreign Bodies*
Foreign-Body Reaction
Humans
Inflammation
Magnetic Resonance Imaging
Skin

Figure

• 

  Fig. 1 A 9-year-old boy with an unrecognized foreign body retained in the calcaneus. A. Plain radiographs with axial and standing lateral views of the right foot show a tubular geographic osteolytic lesion in the anterior body of the right calcaneus (arrows) with an ill-defined margin and surrounding sclerotic change. B. Sagittal T2-weighted MR image shows a low signal intensity tubular lesion in the anterior body of the calcaneus (arrow) with surrounding high signal intensity tissue (arrowheads). C. Sagittal fat-saturated enhanced T1-weighted MR image reveals non-enhancement of the tubular lesion, suggesting a foreign body (arrow), whereas the surrounding soft tissue is strongly enhanced (arrowheads), suggestive of a foreign body reaction. Note edematous bone marrow enhancement in the body of the calcaneus (open arrows). D, E. Coronal T1-weighted (D) and fat-saturated enhanced T1 weighted (E) MR images show a cortical defect (arrows) on the plantar surface of the calcaneal body, just below the retained foreign body. Note the focal defect with enhancement in the overlying plantar fascia (arrowheads). F. A gross photograph of the extracted wooden foreign body.

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