Why They’re Tricky
Some foreign bodies (metal, gravel) show up clearly on plain X-ray; many (wood, glass, plastic, organic material) do not. Patients often think they removed the entire object - only to develop persistent pain, swelling, drainage, or a tender granuloma weeks later.
Diagnosis
A careful history, exam, and imaging - ultrasound is excellent for radiolucent foreign bodies; CT or MRI is occasionally needed.
Removal
Image-guided, minimally traumatic removal in the office or operating room depending on depth and proximity to important structures (nerves, vessels, tendons). Tetanus status and antibiotic coverage are addressed at the same visit.