Entrapped foreign body: A diagnostic muddle for the radiologist.

Area of Science:

• Oral and Maxillofacial Surgery
• Medical Imaging
• Radiology

Background:

• Accurate foreign body localization is essential for effective treatment planning and minimizing tissue damage during retrieval.
• Plain film radiography is the standard initial screening tool, but it frequently misses foreign bodies, especially radiolucent ones like wood (only 15% visualized).
• Relying on a single radiographic image can lead to missed or misdiagnosed foreign bodies, necessitating alternative imaging techniques.

Observation:

• A unique case presented where a soft tissue foreign body was initially misdiagnosed as osteomyelitis and mandibular fracture on digital panoramic radiography.
• The foreign body was not apparent on the initial panoramic radiographic examination.

Findings:

• Mandibular occlusal radiography successfully detected the foreign body that was entrapped in the soft tissue.
• This case underscores the limitations of panoramic radiography for certain types of foreign bodies.

Implications:

• Occlusal radiography can be a valuable adjunct to panoramic imaging for detecting radiolucent foreign bodies in the mandible.
• Utilizing diverse radiographic techniques improves diagnostic accuracy and patient outcomes in foreign body retrieval cases.
• This approach can prevent misdiagnosis and guide appropriate surgical planning for complex foreign body presentations.