J Korean Soc Magn Reson Med.  2013 Mar;17(1):59-62. 10.13104/jksmrm.2013.17.1.59.

MRI Findings of Intramuscular Foreign Body Injection: A Case Report

• So SY
• Kim HJ
• Choi DL
• Hong SS
• Chang YW
• Park ST

• KMID: 1426754
• DOI: http://doi.org/10.13104/jksmrm.2013.17.1.59

Abstract

There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.

Keyword

Magnetic resonance imaging (MRI); Foreign body granuloma; Foreign body reaction; Intramuscular injection

MeSH Terms

Abscess
Acoustics
Edema
Electric Impedance
Female
Forearm
Foreign Bodies
Foreign-Body Reaction
Granuloma
Granuloma, Foreign-Body
Hematoma
Humans
Inflammation
Injections, Intramuscular
Soft Tissue Neoplasms
Tablets
Tablets

Figure

• 

  Fig. 1 A 26-year-old woman with foreign body injection in both forearms. In the lateral view of plain radiography of the right forearm (a), there is no evidence of radiopaque foreign body material in the ventral portion. MR images of the right forearm T2 axial (b), T1 axial (c), and T1 fat suppressed (FS) enhanced coronal images (d) demonstrate T1 low- and T2 high signal intensity (SI), elongated shaped fluid collection with surrounding irregular T2 high SI, and heterogeneous enhancement (arrows) of the lesion. The lesion is in a deep portion of the flexor digitorum superficialis muscle, which is directly adjacent to the flexor digitorum profundus tendon and muscles. The conglomeration of the numerous T1 and T2 dark SI micro-spots (*) is also noted in the lesion. The conglomerated lesion shows chemical shift artifacts around it, which suggests that the lesion has different tissue character with the fluid collection around it.

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