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A 67-year-old female was referred to secondary care with asymptomatic foreign bodies visible on intra-oral radiographs. Clinical examination was unremarkable. Radiographic examination revealed nine pin-like radio-opaque objects throughout the face and head present on multiple previous imaging modalities. The patient was unaware of their presence and could not account for them. A review of available literature revealed similar objects have been used during acupuncture and cosmetic procedures without complication. As the objects were asymptomatic, the patient was reassured and discharged.
CPD/Clinical Relevance: Routine radiographic examination of patients may reveal the presence of unusual and unexpected findings.
Article
A 67-year-old female was referred to the Department of Oral Medicine at Glasgow Dental Hospital and School in late 2016 seeking a second opinion relating to foreign bodies visible on intra-oral radiographs. This referral was made by Practitioner Services, an NHS body responsible for approving certain courses of dental treatment in general dental practice within Scotland. This patient required a large course of dental treatment and it was felt that a specialist opinion regarding the origin of the objects identified on the radiographs was required.
On presentation, the patient did not have any complaints relating to the objects present in the head and neck region as they were entirely asymptomatic. The patient reported being unaware of their presence until alerted by her general dental practitioner. The patient described an episode of trauma in the 1980s; the exact nature of her injuries is unclear from this incident, however, it did result in some right-sided weakness. She also reported periods of significant illness in Malaysia. She stated that on one of these occasions she was taken for emergency treatment in Malaysia where she received a combination of hypnosis and acupuncture, using 22 carat gold needles. The patient reported that she had received this treatment to her head and neck region and other areas of her body.
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