Self-embedding Behavior: Radiologic Management of Self-inserted Soft-Tissue Foreign Bodies

Young, Adam S.; Shiels, William E.; Murakami, James W.; Coley, Brian D.; Hogan, Mark

doi:10.1148/radiol.10091566

Cited by 35 publications

(26 citation statements)

References 28 publications

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“…Foreign body removal Ultrasound has been utilized in diagnosis and treatment of various types of foreign bodies within the soft tissue including wood, plastic, and other radiolucent objects [69][70][71][72] . There is evidence to support the use of ultrasound as a screening tool for foreign bodies and identification of critical neighboring structures that may present difficulty during the removal the object in question.…”

Section: Other Potential Usesmentioning

confidence: 99%

“…In situations where the exact nature of the foreign object is unknown, imaging methods such as MRI may be contraindicated due to the migration risk of metallic objects. Although the evidence is still limited, the use of ultrasound guidance during the removal of foreign bodies should be considered in appropriately selected cases [69][70][71][72][73] .…”

Section: Other Potential Usesmentioning

confidence: 99%

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Ultrasound-assisted musculoskeletal procedures: A practical overview of current literature

Royall¹

2011

WJO

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Traditionally performed by a small group of highly trained specialists, bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and treatment. Due to this limitation, a need evolved for more portability and accessibility to allow performance of emergent musculoskeletal procedures by adequately trained non-radiology personnel. The emergence of ultrasound-assisted bedside techniques and increased availability of portable sonography provided such an opportunity in select clinical scenarios. This review summarizes the current literature describing common ultrasound-based musculoskeletal procedures. In-depth discussion of each ultrasound procedure including pertinent technical details, indications and contraindications is provided. Despite the limited amount of prospective, randomized data in this area, a substantial body of observational and retrospective evidence suggests potential benefits from the use of musculoskeletal bedside sonography.

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Section: Other Potential Usesmentioning

confidence: 99%

Section: Other Potential Usesmentioning

confidence: 99%

Ultrasound-assisted musculoskeletal procedures: A practical overview of current literature

Royall¹

2011

WJO

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“…Sonography is able to detect nonradiopaque objects such as wood and plastic, as well as radiopaque objects, and may be used to guide percutaneous removal. [19][20][21][22] Limitations of the present study include its small sample size (N ϭ 11); a homogeneous sample, obtained from a single source (a large quaternary children's hospital radiology department from 2005-2008) and characterized by patients in out-of-home placements; and use of retrospective data restricted to contents of a clinical chart. In particular, although all of the study patients had diagnoses of bipolar disorder, the clinical chart did not include data pertaining to whether SEB occurred during a manic episode.…”

Section: Figurementioning

confidence: 99%

Self-Embedding Behavior: A New Primary Care Challenge

Bennett¹,

Shiels

Young³

et al. 2011

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Self-embedding behavior is an extreme form of self-injury involving the insertion of inanimate objects into the soft tissues, either under the skin or into muscle. To date, no case series data on this behavior among adolescents has been described in the pediatric medical literature. WHAT THIS STUDY ADDS:Goals of this study are to begin to develop a clinical picture of adolescents who engage in selfembedding behavior, resulting in an understanding that allows practitioners to pursue rapid and targeted intervention to interrupt the cycle of self-harm and institute appropriate longterm therapy.abstract OBJECTIVE: The goal of this study was to define self-embedding behavior (SEB), develop a clinical profile of adolescents who engage in SEB, and emphasize the importance of rapid, targeted, and effective identification and intervention. METHODS:As part of a retrospective study with a database evaluating 600 patients percutaneously treated for soft-tissue foreign body removal, adolescents were identified with self-embedded soft-tissue foreign bodies. We describe patients' gender, age, and psychiatric diagnoses; SEB age of onset, frequency, and self-reported reasons; and the number, type, location of, and removal technique for objects. RESULTS:Eleven patients (9 females) who engaged in SEB were identified. Ten of the 11 patients were members of a group home or psychiatric facility at the time they engaged in SEB. All patients had previous and multiple psychiatric diagnoses. SEB mean age-of-onset was 16 years, and mean number of SEB episodes per patient was 1.9. The most common self-reported purpose for SEB was suicidal ideation (6 of 8 [75%]) versus nonsuicidal ideation (2 of 8 [25%]), with 3 cases lacking this documentation. The mean number of objects embedded in a single episode was 2.4, usually composed of metal and embedded in the arm. Seventy-six foreign bodies were percutaneously removed (using ultrasound or fluoroscopic guidance), including metal, glass, wood, plastic, graphite, and crayon. CONCLUSIONS:SEB is an extreme form of self-injury requiring aggressive and timely interdisciplinary assessment and treatment. An understanding of SEB allows medical professionals to pursue rapid, targeted, and effective intervention to interrupt the cycle of self-harm and institute appropriate long-term therapy. Pediatrics 2011;127:e1386-e1391

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“…1 Retention of foreign body in the soft tissue is associated with complications like infection, tendon injury, non healing sinus, necrotizing fasciitis. 2,3,4 Foreign body granuloma may mimic soft tissue neoplasm.…”

Section: Introductionmentioning

confidence: 99%

Wooden foreign bodies in soft tissue: role of tissue harmonic sonography

et al. 2014

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Background: Wooden foreign bodies (WFB) are usually not detectable on radiography. Ultrasound is a useful tool for detection and localization of WFB. Objectives: We evaluated the efficacy of tissue harmonic sonography in detection of WFB and describe the imaging features of WFB on tissue harmonic imaging. Methods: We retrospectively evaluated 28 patients with history of wooden (wood/thorn/bamboo) foreign body prick with tissue harmonic sonography. Results: The WFB was detected on ultrasonography in all 28 patients (100%) which was confirmed on surgery or follow up study. All WFB were echogenic casting strong posterior acoustic shadowing with or without surrounding hypoechoic halo. Conclusion: Tissue harmonic imaging is useful tool for detection and localization of retained WFB.

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Self-embedding Behavior: Radiologic Management of Self-inserted Soft-Tissue Foreign Bodies

Cited by 35 publications

References 28 publications

Ultrasound-assisted musculoskeletal procedures: A practical overview of current literature

Ultrasound-assisted musculoskeletal procedures: A practical overview of current literature

Self-Embedding Behavior: A New Primary Care Challenge

Wooden foreign bodies in soft tissue: role of tissue harmonic sonography

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