Wooden splinter induced 'pseudotumors' and 'osteomyelitis like lesions' of bone and soft tissue

When a toothpick or other wooden splinter is embedded in the soft tissues, chronic irritation occurs and secondary infection is commonplace. It is likely that both of these factors lead to the bone and soft tissue changes which result in socalled 'pseudotumors' or 'osteomyelitis like lesions'. Delay in diagnosis is not uncommon, for the history of foreign body embedment may be nebulous. However, when the roentgenographic findings of: deep soft tissue thickening or swelling; periosteal new bone reaction; or osteolytic or osteoblastic bone change are seen in the presence of prolonged soft tissue infection, with or without a draining sinus, the diagnosis of such a chronically embedded foreign body should be strongly suspected. Surgical exploration and removal of the foreign body is mandatory, for if the foreign body is not removed, inflammation and infection do not resolve. If the foreign body is removed, complete clinical and roentgenographic resolution is the rule.