Case d. A 2-year-old boy complains of pain after stepping on a toothpick. His father suspects that part of the toothpick remains embedded. Examination reveals a plantar puncture wound but no sign of a foreign body. Radiography shows no deformity. An ultrasound is ordered and reveals a toothpick segment.
With local anesthesia and ultrasound guidance, the splinter is easily removed and the patient is discharged.
For more information, see “Capturing Elusive Foreign Bodies With Ultrasound.” Emergency Medicine. 2009 June;41(6):36-42.