In general, there is very little need for ancillary tests in most patients with traumatic wounds, with the exception of possible imaging studies to detect and locate retained foreign bodies. Foreign bodies are suggested by either the mechanism of injury, persistent foreign-body sensation reported by the patient, or palpation of a hard object by the examining physician. Fortunately, pieces of metal, glass, gravel, teeth, and bone larger than 1 mm are readily visible on plain radiographs when taken using the soft tissue technique and with multiple views to avoid overlapping bone (see Chap 42, "Soft Tissue Foreign Bodies"). Unfortunately, some foreign bodies (plastic, wood, and other organic material) are radiolucent and not visible on plain radiographs. For these objects, computed tomography is the best imaging modality for detection and localization. Ultrasound, though attractive, does not have the required sensitivity to exclude a retained foreign body under clinical circumstances.
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