An unusual bone reaction to a retained organic foreign body in the hand

Abstract

Penetrating wounds of the hand with an embedded foreign body are common in active children and manual workers. Organic material, particularly thorns, can cause an inflammatory tissue reaction, ranging from a localized foreign body granuloma to a severe soft tissue and osseous reaction. We report the case of a 57-year-old man presented to our emergency department with a painful swelling of his fourth right finger. He had fallen into bushes 4 month prior to his presentation. Plain radiographs showed a solid periosteal new-bone formation along the second phalanx, interrupted by a rounded well-limited radiolucent area at the mid-phalangeal level that we described like a “crab claw periosteal reaction”. The osteoblastic reaction to an organic foreign body is very rare, we report an exceptional case of an unusual osteoblastic reaction to a retained organic foreign body in the hand that has been to our knowledge only once reported in the literature.