TY - JOUR T1 - A nose out of joint: first reported case of prison-acquired marijuana-based rhinolith JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-231989 VL - 12 IS - 10 SP - e231989 AU - Murray Smith AU - Eugene Wong AU - Navid Ahmadi AU - Narinder Pal Singh Y1 - 2019/10/01 UR - http://casereports.bmj.com/content/12/10/e231989.abstract N2 - Rhinoliths are calcareous concretions of the nasal cavity formed around a nidus that may be endogenous (eg, dislodged tooth) or an exogenous foreign body (eg, plastic bead inserted by a child). Rhinoliths are often found incidentally on endoscopy or imaging to assess for other pathologies. The incidence is estimated to be 1 in 10 000 of all otolaryngology outpatient presentations, but this is likely to be an underestimate due to the often asymptomatic nature of this condition. We describe the unique case of a rhinolith that developed from a marijuana-filled balloon that the patient attempted to smuggle into a correctional facility. After inserting the package into his nostril, the patient then mistakenly believed it had been accidentally swallowed. Despite experiencing persistent symptoms of nasal obstruction and recurrent sinonasal infections, the marijuana package was only discovered 18 years after insertion following imaging for an unrelated indication ER -