Diagnosis of toothpick-induced chronic intramuscular abscess using fistulography in a dog

Abstract

A ten-year-old, 16.7 kg mixed-breed dog presented with chronic lameness and delayed healing of discharging wounds in the right pelvic limb following a puncture injury for approximately 6 months. Debridement surgery had been performed, but the tissue infection was persistent. Plain radiographic examination showed neither increased soft tissue opacity nor foreign body (FB) existence near the discharging wound of the right pelvic limb. After the second debridement surgery, closed drainage tubes were placed, and susceptible antibiotic therapy was prescribed in an attempt to control the persistent infection, but the fluid draining from the wound was still purulent. Therefore, fistulography was performed using a closed drainage tube, the radiopaque contrast medium successfully outlined a linear FB, approximately 6 cm long, present cranial to the right femoral greater trochanter and parallel to the ilium body. A wooden toothpick, approximately 6 x 0.2 cm, was subsequently retrieved from the sartorius muscle, and the dog had a subsequent full recovery. Here, we describe successful presurgical diagnostic imaging and treatment of a chronic intramuscular abscess caused by toothpick retention.