Delayed presentation of a retained radiolucent wooden foreign body in a child

A boy in middle childhood presented with a 1-month history of intermittent discharge from sinus openings on the posterior aspect of the left forearm. Examination revealed two small draining sinus tracts with mild surrounding erythema and induration but no systemic features. Routine blood investigations, plain radiographs and ultrasonography were unremarkable. The draining sinuses and local inflammatory changes were considered consistent with a localised chronic infection; surgical exploration was therefore undertaken and a 9 cm wooden fragment was identified within the posterior extensor muscle plane. The fragment was removed intact and the sinus tracts were excised. The boy recovered uneventfully, regained full elbow, wrist and finger motion and had no recurrence at the 1-year follow-up. This case demonstrates that radiolucent organic foreign bodies may remain occult on routine investigations and that material-specific imaging knowledge, anatomical localisation and persistent clinical suspicion are essential.