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Related Experiment Videos

Lead synovitis in the hand: a case report.

N Watson, G P Songcharoen

    Journal of Hand Surgery (Edinburgh, Scotland)
    |October 1, 1985
    PubMed
    Summary

    A .177 air rifle pellet lodged in a boy's finger joint caused lead synovitis and elevated blood lead levels. Prompt removal of the foreign body is crucial for managing joint and systemic lead toxicity.

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    Area of Science:

    • Orthopedics
    • Toxicology
    • Pediatric Medicine

    Background:

    • Foreign body injuries in children can lead to unique complications.
    • Lead exposure from embedded projectiles is a recognized but uncommon concern.
    • Metacarpophalangeal joint involvement presents specific diagnostic and management challenges.

    Observation:

    • A thirteen-year-old male presented with a .177 caliber air rifle pellet embedded in the metacarpophalangeal joint.
    • Clinical signs included joint inflammation (synovitis) and laboratory evidence of elevated serum lead levels.
    • The presence of lead within the joint space was confirmed.

    Findings:

    • The embedded air rifle pellet served as a source of chronic lead exposure.
    • Lead synovitis, an inflammatory reaction within the joint due to lead, was diagnosed.
    • Systemic lead toxicity was evidenced by significantly raised serum lead levels.

    Implications:

    • This case highlights the potential for seemingly innocuous projectiles to cause significant lead poisoning.
    • Early surgical exploration and removal of intra-articular foreign bodies are essential to prevent lead synovitis and systemic toxicity.
    • Clinicians should maintain a high index of suspicion for lead toxicity in pediatric patients with embedded projectiles, regardless of the projectile type.

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