Disclosures: Ihsan Balkaya, MD: No financial relationships or conflicts of interest

Case Diagnosis: Multiple glass foreign bodies in the neck.

Case Description: A 60-year-old male presented with 18-year history of sharp, anterior neck pain. His pain started when he accidentally drank a broken piece of a glass dropper. Over the following years, the patient had numerous medical evaluations from many professionals and underwent multiple imaging studies including MRIs, CT, and EGDs with unremarkable study results to work up his pain. However, his symptoms persisted, with an intermittent sensation of foreign body migration in his neck. His ensuing physical exam was not notable for any abnormality except tenderness to palpation on bilateral carotid and the muscular triangle of the neck.

Discussion: Ultrasound (US) is a widely used tool in musculoskeletal medicine because of its several advantages; it is inexpensive, convenient, has excellent resolution, and provides a dynamic assessment. It can also be used to detect foreign bodies when initial radiography fails due to its advantage in localization of radiopaque and radiolucent materials in soft tissue structures. Although the glass is radiopaque, its radiopacity can be compromised in clinical settings due to its minute size of the fragment and overlapping structures.

Setting: Outpatient ClinicAssessment/

Results: A complete sonographic exam demonstrated multiple hyperechoic foci consisted of foreign bodies in the neck. On the right side just medial to the common carotid artery (CCA) measuring 5mm, two fragments identified on the left, medial to CCA measuring 4mm. The additional fragment was detected close to the left suprasternal notch measuring 6mm. The patient was referred to surgery.

Conclusion: High-resolution ultrasound is useful for the detection of small foreign bodies that are difficult to detect with other diagnostic imaging. Glass foreign bodies have a high risk of delayed migration, possibly result in unpredictable complications and cause significant morbidity and mortality risk, months or years after the traumatic event.

Level of Evidence: Level IV

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-diagnostic-utility-of-ultrasound-in-detecting-glass-foreign-bodies/