Retained rubber foreign body mimicking mid foot multi focal osteomyelitis – A case report

Abstract

Background: Retained rubber foreign bodies following penetrative foot trauma are rare. The subsequent tissue reaction that develops in response to encapsulating it results in a foreign body granuloma, which clinically and radiologically mimics various infective and tumorous conditions of bone. The possibility of having retained foreign bodies should be considered years after injury, clinical and radiological findings should be differentiated from multifocal chronic osteomyelitis. Case report: An 18-year-old male presented with left midfoot pain, swelling, and discharging sinus since 1 year in 2020. He had sustained a wood splinter injury through his rubber footwear in 2017 and developed foot pain and swelling which on investigation revealed mid-foot bony lesions. With indigenous treatment, he reported extrusion of a small wooden splinter from the foot. On presenting with the above complaints, new investigations revealed bony lesions with surrounding soft-tissue edema, abscess, and sinus tract. Considering it to be chronic osteomyelitis, debridement and curettage were performed, and unexpectedly a rubber foreign body was identified and microbiological tests with histopathology findings confirmed an aseptic foreign body reaction. Conclusion: With penetrative foot injuries, the possibility of having more than one radiolucent foreign body (wood and rubber) retained, following a single impaling injury and its osteolytic lesions could be a sequela of foreign body granuloma presenting years later.

Keywords

• Foreign body
• Rubber
• Granuloma
• Chronic osteomyelitis