Thorn-induced non-specific granulomatous left biceps myositis with left subareolar lymphadenopathy

In surveying the pediatric and orthopedic literature, very little has been written about foreign bodies in skeletal muscle or muscle tissue inflammation in response to foreign bodies. When it is known that a foreign body has penetrated the muscle or if it is externally visible, there is no diagnostic problem. However, this can become a perplexing problem when history and physical examination are not clearly diagnostic. We present a case in which a thorn penetrated the left biceps muscle of a 10-year-old girl. The thorn remained there for 3 weeks without disturbing the child. It produced a local sterile granulomatous reaction in the muscle. Two weeks later, left subareolar lymphadenopathy appeared with no involvement of the axillary lymph nodes.