SA Orthopaedic Journal
Print version ISSN 1681-150X
Although foreign-body injuries are quite common, 15 to 55 per cent of these are misdiagnosed at the initial emergency room visit.1 The normal clinical course of a foreign-body injury is that of sudden pain at the time of injury followed by a dormant asymptomatic phase that can last from one month to a couple of years.1 The patient can, however, develop an acute flare-up at any stage. The length of this dormant phase may obscure the inciting incident, thus separating it from the onset of these 'late' symptoms. Another problem leading to the occasional incorrect diagnosis is caused by the composition of the foreign body. If the foreign body is radiopaque it is easily detected on a standard radiograph or fluoroscopy. The problem arises when the foreign body is not radiopaque, as is the case with a wooden splinter or thorn. These can remain undetected even with surgical exploration and will only become evident when a toxic reaction to the foreign body causes inflammation with synovitis due to local irritation. We present a case report of Achilles tendonitis secondary to a retained thorn of the date palm (Phoenix caneriensis).