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- Wood foreign body appearance on CT
Christopher R. Lamb, Elizabeth H.W. Pope, Karla C.L. Lee
Background: Wooden foreign bodies in dogs are challenging to detect due to variability in clinical presentations and imaging appearances. Acute injuries often result from penetrating trauma (e.g., stick injuries), while chronic cases may involve abscess formation or migration of the foreign body. The study aimed to describe the clinical and computed tomographic (CT) findings associated with wooden foreign bodies in dogs, examine differences between acute and chronic cases, and evaluate the accuracy of CT for their detection.
Methods: A retrospective, cross-sectional study analyzed data from 72 dogs at a veterinary hospital (2005–2015). Inclusion criteria included CT imaging and surgical exploration for suspected wooden foreign bodies. CT findings were reviewed by a radiologist, and data such as clinical signs, duration, and wood type were collected. Statistical analyses included sensitivity, specificity, and comparisons of CT findings between acute (<7 days) and chronic (≥7 days) cases.
Results
Prevalence and Types of Foreign Bodies: Wooden foreign bodies were confirmed in 55 dogs, including tree branches (60%), kebab sticks (15%), and other wooden objects.
CT Accuracy: Sensitivity was 79% (95% CI: 65–89%), and specificity was 93% (95% CI: 78–98%). Positive and negative likelihood ratios were 11.5 and 0.23, respectively.
Differences Between Acute and Chronic Cases:
-Acute cases (67%) were associated with wounds (P = 0.001) and gas in soft tissues (96%; P < 0.001).
-Chronic cases (33%) had higher rates of draining sinuses (17%; P = 0.01), cavitary lesions (50%; P = 0.002), fat stranding (38%; P = 0.01), and periosteal reaction (17%; P = 0.01).
Characteristics of Foreign Bodies: Median dimensions were 48 mm length (range 2–270 mm) and 3 mm thickness (range 1–22 mm). Median attenuation varied (−344 to +640 HU), with differences observed between acute and chronic cases (P = 0.05).
Limitations: The retrospective design may have led to selection bias, as some dogs with undetected foreign bodies may not have been included. Review bias was possible, as images were analyzed with knowledge of surgical findings. Additionally, comparisons with other imaging modalities were limited.
Conclusions: CT demonstrated moderate sensitivity and high specificity for detecting wooden foreign bodies in dogs, with distinct imaging patterns for acute and chronic cases. The findings highlight the importance of careful CT evaluation, including noncontrast and multiplanar reconstructions, to improve diagnostic accuracy. CT is recommended for suspected penetrating or ingested wooden foreign bodies in dogs, especially when other imaging modalities fail to identify them.
Examples of the CT appearance of wooden foreign bodies. (A) Transverse, noncontrast CT image (level 50 HU, width 350 HU) showing two relatively dense (110 HU) angular wood splinters (arrowheads) lodged in the base of the tongue of a dog with chronic signs of swelling (*), dysphagia, and pyrexia. Foci of gas are visible dorsal to the wood fragments. (B) Oblique, noncontrast CT image (level −500 HU, width 2000 HU) showing a tree branch (between arrowheads) (−342 HU) lodged in the axilla following an acute penetrating injury. Multiple small gas foci are present in the adjacent tissues. (C) Transverse, postcontrast CT image (level 50 HU, width 350 HU) of the caudal abdomen showing a well-defined, linear lucent tract through the left gluteal muscles of a dog that had an acute penetrating wound. (D) Same image as C displayed using a lung window (level −500 HU, width 2000 HU). The foreign body (−320 HU) is now visible as wood with a low density core. A piece of garden cane was removed surgically.
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