Delayed Presentation of Retained Glass Foreign Body in Foot

Case at a Glance

A 28-year-old male presents with a retained glass fragment in his foot that occurred 2 years prior, now causing increasing discomfort with weight-bearing activities.

Patient's Story

The patient sustained a glass injury to the lateral aspect of his right foot near the fifth toe while walking on a beach approximately 2 years ago. At the time of injury, he did not seek medical attention and the wound appeared to heal over the foreign body. The patient has been asymptomatic until recently, when he began experiencing discomfort when wearing shoes and during physical activities such as hiking, weightlifting, and running. He reports that the glass fragment is palpable and visible beneath a callus that has formed over the area.

Initial Assessment

Physical examination reveals a small callus on the lateral aspect of the right foot adjacent to the fifth toe. The glass fragment appears to be superficial and is both palpable and visible beneath the overlying tissue. The patient demonstrates point tenderness over the area and reports pain with pressure application. No signs of active infection are present.

The Diagnostic Journey

Given the clear history of glass penetration and the ability to visualize and palpate the foreign body, imaging studies were not deemed necessary for diagnosis. The patient's symptoms of recent onset pain with weight-bearing activities correlating with the known location of the retained glass fragment supported the clinical diagnosis.

Final Diagnosis

Retained glass foreign body in the right foot with overlying callus formation and secondary mechanical irritation

Treatment Plan

Referral to podiatry for foreign body removal was recommended as the primary treatment approach. Alternative options discussed included urgent care evaluation if the fragment appears superficial enough for simple removal. The patient was advised that removal would likely be a minor office procedure given the superficial location and visibility of the glass fragment.

Outcome and Follow-up

The patient was counseled on appropriate specialist referral options and insurance considerations. He was advised to seek prompt removal to prevent further irritation and potential complications. Follow-up care would be determined based on the complexity of the removal procedure and healing progress.