Ultrasound‐assisted foreign body extraction (U‐SAFE): Review of technique and technical pearls

Introduction Soft tissue foreign bodies are a common presentation to emergency departments and primary care. They have variable presentations and associated morbidity depending on their acuity, location, functional impairment and neurovascular involvement. Traditional removal has utilised blind technique or surgical exploration. Their removal can be difficult secondary to induration, inflammation, granulation and scar tissue. Ultrasonography has emerged as a minimally invasive and inexpensive method of examination and retrieval. This article entails ultrasound‐guided foreign body extraction with associated pearls of experience. Methods From March 2017 to August 2020, a fellowship trained interventional radiologist and a fellowship trained musculoskeletal radiologist performed 52 foreign body extractions under ultrasound guidance at a single institution. Results 52 foreign body extractions occurred over 3‐year time period with a 95% success rate. The most common location of foreign body was the finger (62%) and feet/toes (17%). Foreign bodies identified include wood (31%), plant‐based material (29%), metal (17%), glass (17%) and synthetic material (6%). Two unsuccessful cases were secondary to delayed presentation with significant foreign body reaction and the 2nd due to patient psychiatric issues. There were no identified complications. Conclusion Ultrasonography‐guided foreign body extraction is a minimally invasive, efficient and targeted technique for foreign body removal.