CT is capable of detecting more types of foreign materials than plain-film radiography because it is 100 times more sensitive in differentiating densities. 610 Subtle density differences can be distinguished with a narrow radiographic density window adjustment, particularly if a computer workstation is used to vary the gain and contrast settings.10 Thorns, spines, wood toothpicks, and plastic foreign bodies have been identified with this method. CT may detect objects embedded in bone, and isodense objects may be outlined by surrounding air within the wound. Digital edge enhancement can further improve the visibility of these objects. 9 CT images can be created in multiple planes and can demonstrate the relationship of a foreign object to important anatomic structures. The principal disadvantages of CT are its cost and higher radiation dose. However, even CT may not demonstrate thorns, spines, and some types of wood. Wood may have a CT pattern that is similar to a gas bubble or bone fragment.9 As wood absorbs fluid from tissue, it becomes isodense and difficult to distinguish from surrounding tissue.
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