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Chapter 26 Foreign Bodies

Chapter 26 Foreign Bodies. Abdomen and Superficial Structures. Objectives. Identify and give examples of different types of soft tissue foreign bodies based on composition. Explain sensitivity and specificity.

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Chapter 26 Foreign Bodies

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  1. Chapter 26Foreign Bodies Abdomen and Superficial Structures

  2. Objectives • Identify and give examples of different types of soft tissue foreign bodies based on composition. • Explain sensitivity and specificity. • List the important information the sonographer should obtain from the patient interview and patient chart prior to providing a comprehensive sonography evaluation. • Differentiate the different sonographic appearances of soft tissue foreign bodies based on composition, location, age, and artifacts.

  3. Objectives • Describe the role of the sonographer prior to, during, and following sonography guided foreign body removal. • Explain the limitations of sonography and the advantages of other imaging modalities used to image soft tissue foreign bodies.

  4. Composition of Foreign Bodies Radiography detects only 15% or less of radiolucent foreign bodies (wood, plastic, glass, and cactus spine)

  5. Transducer • Large Footprint Screening • 7-12 MHz • High Resolution

  6. Increasing Near Field Length Water Bath Technique • Increase visualization of skin surface.

  7. Increasing Near Field Length

  8. Edge Shadowing Artifacts

  9. Speckle Reduction Imaging & Hyperemic Flow Inflammatory Rxn

  10. Using Anatomy to Locate Foreign Bodies

  11. Foreign Body Location

  12. Age of the Foreign Body

  13. Shadowing

  14. Hypoechoic Rim

  15. Granuloma Formation • <Insert Figure 26-12A-B>

  16. Appearance of Retained Foreign Bodies

  17. Sonogram of Foreign Body and Air Mimicking Foreign Bodies

  18. Documenting Foreign Body Location • <Insert Figure 26-15A-B>

  19. Sonography-Assisted Removal • Forceps Needle

  20. Limitations • Varying imaging angles can decrease differentiation from bone • Wound exploration or irrigation may decrease air bubbles in field of view • Lidocaine injection • False positives

  21. Summary • The sonography examination relies on the skill, knowledge, and accuracy of the sonographer who pays attention to the composition, location, age, and artifacts associated with foreign bodies. • The experienced sonographer has an important role prior to, during, and following sonography-guided foreign body removal.

  22. Summary • Recognizing foreign body detection and removal is a unique and evolving application of emergency sonography. • Sonography should become the main imaging tool used for the detection and localization of soft tissue foreign bodies because of its sensitivity, it is noninvasive, and it provides a high-resolution, real time evaluation.

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