Retained toothpick causing pseudotumor of the first metatarsal: a case report and literature review

We present a case of a retained toothpick causing pseudotumor of the first metatarsal in a young female who was referred as a case of painless swelling in the dorsolateral aspect of the right foot to exclude a malignant tumor. Plain radiograph did show an osteolytic lesion in the head and neck of the first metatarsal. Magnetic resonance imaging revealed a toothpick inside the first metatarsal head. Surgical exploration revealed a 4 cm toothpick embedded inside the bone surrounded by granulation tissue. We could find seven cases of retained foreign bodies causing osteolytic lesions in the metatarsals of the foot with one case of osteomylitis in an adult due to a retained small piece of toothpick. Retained foreign body should be considered in the differential diagnosis of an osteolytic lesion of the foot.