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Unusual ultrasound diagnosis of hair implantation osteomyelitis of the thumb
  1. Chie Katsura and
  2. Cher Bing Chuo
  1. Department of Plastic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
  1. Correspondence to Cher Bing Chuo; cherbing.chuo2{at}


Osteomyelitis is a challenging condition to diagnose and successfully treat. A clinician diagnosing osteomyelitis is reliant on relevant aspects of clinical history, inflammatory markers and radiological imaging such as X-rays, CT and contrast MRI. The confirmation of the presurgical diagnosis is made from microbiological analysis of the bone biopsy and/or histological analysis for features of inflammatory changes. An ultrasound scan is generally thought to have less value in osteomyelitis diagnosis due to its inability to interrogate bone. However, this investigation can be helpful in detecting the site and size of soft tissue collections secondary to osteomyelitis and the presence of any associated foreign bodies. We present a case where an ultrasound scan played a key role in supporting the diagnosis of osteomyelitis of the thumb in a dog groomer. This is the first reported case of hair implantation osteomyelitis presenting without a cutaneous sinus.

  • Bone and joint infections
  • Radiology
  • Plastic and reconstructive surgery
  • Orthopaedic and trauma surgery
  • Musculoskeletal and joint disorders

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  • Contributors CK and CBC have contributed to the planning, conduct, reporting, conception and design of this paper. All authors have made an individual contribution to the writing of the article and/or have been involved with the patient’s care. Both authors were involved in drafting and revising the article critically. The authors agree to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.