Sea urchin granuloma: a chronic complication of sea urchin spine injuries

Muroyama, Yuki; Nagumo, Masato; Fujishima, Fumiyoshi; Suzuki, Takashi

doi:10.1093/qjmed/hcad238

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Delayed effects and possible long-term complications usually depend on whether the spines penetrate tendons, tendon sheaths, bones, or joints and/or become infected. Complications may include arthritis, granulomas, impaired function, synovitis, persistent neuropathy and tendinopathy, chronic arthropathy, and delayed hypersensitivity reactions [3,22,26,33,[36][37][38][39][40]. Additionally, secondary infections and tetanus may manifest due to the presence of a lodged foreign body [3,41].…”

Section: Toxins Immediate and Delayed Reactions And Infectionsmentioning

confidence: 99%

Sea Urchin Spine Embedded in the Sole of the Foot: Eight-Year Radiographic Follow-Up Without Removal

Skedros,

Richards

et al. 2024

Cureus

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When sea urchin puncture injuries occur during coastal recreation or work activities, they often affect extremities, such as hands and feet. There is a plethora of information on treatments for these puncture injuries, with the most common among medical professionals being the removal of all partially embedded spines and the removal of as many fully embedded spines as possible. When the spines are deeply embedded and/or fragmented, they might not be removed, especially when they are not located in critical areas such as tendons or joints. This reflects the generally held notion that smaller spines and spine fragments will eventually dissolve or be absorbed. Here we report an unusual case where the tip of a sea urchin spine became embedded in the soft tissue of the sole of the foot of a 21-year-old male after he stepped on one after falling off a kayak off the coast of Oahu, Hawai’i. The deeply embedded spine was not removed. By three weeks after the injury, the patient did not have any symptoms, and eight years later, he was still symptom-free. Radiographs taken one year after the injury showed that the spine had fragmented into two pieces. The smaller piece was about 15% of the size of the original embedded spine, and it had apparently been absorbed (it was not seen on final radiographs eight years later). Analysis of radiographs eight years after the injury showed that the main or large spine fragment was still distinctly detectable in the soft tissue; there was no visible evidence that it had undergone significant absorption or migrated from the original location. The absence of any obvious radiographic rarefaction over eight years is contrary to the lore that sea urchin spines that remain in human soft tissue will exhibit significant, or complete, absorption or dissolution over months to a few years.

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