A 29-year-old man presents to the ED with a foreign body (FB) in his right leg. He was impaled by an organic thorn while doing yard work in his backyard roughly 3 hours prior to presentation. A sample of the type of plant that was inserted into his lower extremity is shown in figure 1. He reports pain with movement of the limb, but no numbness or tingling.

Sample of the type of plant that was embedded in the patient’s wound.

On examination, he is well appearing with normal vital signs. There is a small 2–3 mm wound inferolateral to the right knee with very mild associated erythema, no active bleeding or swelling and no palpable FB (figure 2).

A small 2–3 mm puncture wound can be seen inferolateral to the right knee (arrow).

A point-of-care ultrasound (POCUS) was performed to evaluate for the presence of an FB using a high frequency (6–13 MHz) linear array ultrasound (US) transducer.

The patient was found to have evidence of an FB inferior to the small opening in his right leg measuring 3.35 cm on US (figures 3 and 4). The FB appeared as hyperechoic, with no evidence of reverberation artefact or a hypoechoic halo. After identification, POCUS was used for localisation and ultimately the removal of the organic FB: a thorny portion of the plant brought in by the patient (figure 5). After consultation with the ED pharmacist, the patient was discharged home with a course of amoxicillin–clavulanate for infection prevention, along with return precautions and follow-up with his primary care physician as needed.

Point-of-care ultrasound using a linear transducer of an echogenic organic foreign body.

Foreign body measuring 3.35 cm.

Approximately 3 cm organic foreign body removed from the patient’s leg shown next to a ruler.

POCUS may be performed for a …