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Chapter 26 Foreign Bodies

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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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