Forgotten Foreign Bodies Mimicking Osteomyelitis, a Diagnostic Dilemma - A Report of Two Cases

The first differential diagnosis for a chronic discharging sinus on an extremity is usually chronic osteomyelitis. These patients are usually treated with surgical debridement and intravenous antibiotics. However, all discharging sinuses are not osteomyelitis.

We encountered two such cases, initially treated as osteomyelitis, which did not respond to initial surgical debridement and, on further workup, were found to have foreign bodies in situ that mimicked osteomyelitis. The first case is a 1 ½-year-old child with an intact rubber band inside the wrist, presenting with sinuses on the wrist, and the second one is a 12-year-old with an old penetrating injury to the foot through the sole of a rubber slipper. Both patients recovered completely once the foreign bodies were removed.

We stress the importance of keeping the possibility of a foreign body in mind in patients with discharging sinuses not responding adequately to debridement and antibiotics.