Unusual application of twinkling artifact

Introduction: The aim of this paper is to show how to improve diagnostic accuracy using CDUS and twinkling artifact in patients experiencing discomfort due to the presence of small FBs in the soft tissues not clearly visible at US grayscale examination. Materials and methods: We enrolled 7 adult patients presenting with small (2-4 mm) superficial FBs located in the subcutaneous and muscle tissues, barely or not detectable on US grayscale. All patients underwent US grayscale and CDUS examinations. Results: We identified superficial FB with twinkling artifact in all 7 patients. All of these were confirmed to represent foreign bodies after surgical excision. Conclusion: TA is useful in the evaluation of subcutaneous and muscular FBs and provides information on their location, depth and shape, which is useful if surgical excision is required.