Silver nitrate stain masquerading as a heterotopic ossification

Vu, Peter; Faraday, Richard; Vu, Dan; Kim, Joon

doi:10.1016/j.radcr.2020.01.030

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…Healy et al reported two cases in which silver nitrate was incorrectly identified as a foreign body on plain radiographs of the fingers 10 . A similar case has been described by Peter Vu et al, in which, unfortunately, the patient underwent surgical intervention due to the artefactual appearance of fingertip heterotopic ossification 11 …”

Section: Discussionmentioning

confidence: 82%

“…10 A similar case has been described by Peter Vu et al, in which, unfortunately, the patient underwent surgical intervention due to the artefactual appearance of fingertip heterotopic ossification. 11 Overall, silver nitrate has been reported in specialities which deal with inflammatory pathologies relating to bony structures or nearby areas. In the context of OE, it is important to note that other topical agents are also being used e.g.…”

Section: F I G U R E 2 Silver Nitrate Appearing As a Metallic Foreign...mentioning

confidence: 99%

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The erroneous appearance of silver nitrate on computerised tomography imaging in patients with severe otitis externa; a case series

Javed

Hashmi

Qayyum

2022

Clinical Otolaryngology

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Silver nitrate has been used in surgical practice for centuries. It was first described in 1829 by Higginbottom for the management of inflammatory wounds and ulcers. 1 Silver nitrate is an inorganic compound and when exposed to water, it ionises into free silver ions, which acts on tissues and blood vessels causing coagulation necrosis and thrombus formation. 2 Its antiseptic action is now described as being primarily related to apoptosis leading to cell death. 2 Because of these antiseptic and wound healing properties, it is commonly used as a topical agent for cauterising bleeding points; especially over mucosal surfaces, burning granulations and even cauterising the non-healing ulcers for acceleration of the healing process. 3 Granulations in necrotizing otitis externa (OE) are very common and are considered to be one of the diagnostic criteria. 4 These lesions are often managed by applying silver nitrate especially after taking biopsies due to its dual effect. 5 Silver nitrate not only provides haemostasis but further inhibits fibroblast proliferation resulting in rapid resolution of the granulation tissues. 3

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Section: Discussionmentioning

confidence: 82%

Section: F I G U R E 2 Silver Nitrate Appearing As a Metallic Foreign...mentioning

confidence: 99%

The erroneous appearance of silver nitrate on computerised tomography imaging in patients with severe otitis externa; a case series

Javed

Hashmi

Qayyum

2022

Clinical Otolaryngology

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“…9 A similar case was described by Peter Vu et al, in which the patient unfortunately underwent surgical intervention due to the artefactual appearance of fingertip heterotopic ossification. 10…”

Section: Discussionmentioning

confidence: 99%

The Erroneous Appearance of Silver Nitrate on CT Imaging in Patients with Severe Otitis Externa; A Case Series

Javed¹,

Hashmi²,

Qayyum³

2022

Preprint

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Introduction Silver nitrate is commonly used within otolaryngology to treat granulation tissue in severe otitis externa. It appears radio-opaque on CT (computed tomography) imaging and therefore can mimic bony fragments and foreign bodies. This is particularly cumbersome when the phenomena correlates to the clinical complaint. Discussion We report two cases of 73-year-old and 75-year-old males who presented with chronic otalgia and discharge. Granulation tissue in the external auditory canal was identified and chemically cauterised with silver nitrate. Subsequent CT petrous bones demonstrated an unidentified foreign body in the canal with extensive soft tissue swelling giving an impression of a wick in situ and “minor bony erosion in the left external acoustic canal” respectively. An additional CT of a 57-year-old female who had been treated with silver nitrate for granulomatous tissue reported “multiple highly radiopaque foci in the external auditory canal, suggestive of foreign body”. Though relatively unknown, this phenomenon has been reported in literature. However, there are few reports of silver nitrate artefacts in CT images of the head no cases in the context of otitis externa. Our patients avoided further imaging or surgery following clarification with the radiologists and symptomatic improvement with long-term intravenous antibiotics. Conclusion Given the prevalence of CT imaging and cauterization in otolaryngology, we recommend contemporaneously documenting the use of silver nitrate and highlighting this on request forms to avoid alarming erroneous reports, unnecessary investigation and surgical procedures. We also recommend, where clinically acceptable, to use silver nitrate prior to imaging.

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PVC membrane bulk optode incorporating 4-nitrobenzo-15-crown-5 and sodium tetrakis(1-imidazolyl) borate for the pico-molar determination of silver ion in pharmaceutical formulation

Abdel-Haleem,

Alhashemi,

Rizk

2024

Sci Rep

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Silver nitrate stain masquerading as a heterotopic ossification

Cited by 3 publications

References 4 publications

The erroneous appearance of silver nitrate on computerised tomography imaging in patients with severe otitis externa; a case series

The erroneous appearance of silver nitrate on computerised tomography imaging in patients with severe otitis externa; a case series

The Erroneous Appearance of Silver Nitrate on CT Imaging in Patients with Severe Otitis Externa; A Case Series

PVC membrane bulk optode incorporating 4-nitrobenzo-15-crown-5 and sodium tetrakis(1-imidazolyl) borate for the pico-molar determination of silver ion in pharmaceutical formulation

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