{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T06:40:05Z","timestamp":1770446405233,"version":"3.49.0"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,7,28]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>We report a case of a girl in mid childhood, who presented with a 2-month history of painless swelling on the dorsum of her right hand, with an unclear history of fall while playing, around 4\u2009months prior to presentation to us. The child remained asymptomatic during the interim period. Radiographs and ultrasonography were suggestive of osteomyelitis of the index finger metacarpal of the right hand. However, routine blood tests and inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein were normal. She was provisionally diagnosed as a case of chronic osteomyelitis of the index finger metacarpal of the right hand. Surgical exploration showed the presence of an intramedullary foreign body (thorn), along with associated changes in the bone, periosteum and tendon sheath. Removal of the thorn and administration of appropriate antibiotics resulted in complete recovery.<\/jats:p>\n                  <jats:p>This case report highlights the importance of carefully evaluating subtle or non-specific patient histories. It also emphasises the need to consider thorn-induced osteomyelitis as a differential diagnosis, particularly in paediatric patients belonging to rural areas presenting with osteomyelitis of the hand or foot, even in the absence of a clear history of trauma or abnormal blood parameters.<\/jats:p>","DOI":"10.1136\/bcr-2025-266185","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T04:10:17Z","timestamp":1755144617000},"page":"e266185","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Thorn-induced osteomyelitis of the metacarpal of the index finger in a paediatric patient"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6260-3743","authenticated-orcid":false,"given":"Karthik","family":"Baskaran","sequence":"first","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prateek","family":"Behera","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Ashutosh","family":"Santoshi","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dharm","family":"Pal","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"2025081321100800000_18.8.e266185.1","doi-asserted-by":"crossref","first-page":"347","DOI":"10.18295\/2075-0528.2747","article-title":"Orthopaedic Manifestations of Date Thorn Injury: Case series","volume":"8","author":"Suresh","year":"2008","journal-title":"Sultan Qaboos Univ Med J"},{"key":"2025081321100800000_18.8.e266185.2","first-page":"279","article-title":"Injuries from palm tree thorn simulating tumoral or pseudotumoral bone lesions","volume":"67","author":"Vega Curiel","year":"2001","journal-title":"Acta Orthop Belg"},{"key":"2025081321100800000_18.8.e266185.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-022-07280-y","article-title":"The first case report of thorn-induced Alternaria alternata infection of the hand in an immunocompetent host","volume":"22","author":"Kim","year":"2022","journal-title":"BMC Infect Dis"},{"key":"2025081321100800000_18.8.e266185.4","unstructured":"Sahu S , Parichha K . Date Thorne Osteomyelitis of Lower Extremity in Bare Foot Walkers: 5 Cases. International Journal of Orthopaedics Sciences [Internet] 2016. Available: https:\/\/www.semanticscholar.org\/paper\/Date-Thorne-Osteomyelitis-of-Lower-Extremity-in-5-Sahu-Parichha\/2e552c94ed8ff0acba138f70f3c1598505217812"},{"key":"2025081321100800000_18.8.e266185.5","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1053\/j.jfas.2012.10.015","article-title":"Osteitis of the fourth metatarsal caused by a date palm thorn in a child: why the dorsum of the foot is the most commonly injured site","volume":"52","author":"Madhar","year":"2013","journal-title":"J Foot Ankle Surg"},{"key":"2025081321100800000_18.8.e266185.6","first-page":"468","article-title":"The missed thorn","volume":"58","author":"Barry","year":"1992","journal-title":"Acta Orthop Belg"},{"key":"2025081321100800000_18.8.e266185.7","article-title":"Foreign body granuloma: a diagnosis not to forget","volume":"2012","author":"El Bouchti","year":"2012","journal-title":"Case Rep Orthop"},{"key":"2025081321100800000_18.8.e266185.8","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.178.3.1780557"},{"key":"2025081321100800000_18.8.e266185.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(10)80003-6"},{"key":"2025081321100800000_18.8.e266185.10","doi-asserted-by":"crossref","first-page":"10","DOI":"10.36349\/easjop.2023.v05i02.001","article-title":"Acute Metacarpal Osteomyelitis in Children: A Case Report and Review of the Literature","volume":"5","author":"Chniti","year":"2023","journal-title":"EAS J Orthop Physiother"},{"key":"2025081321100800000_18.8.e266185.11","first-page":"100","article-title":"A Sub-acute Septic Arthritis of the Knee; a Sequelae to Thorn Prick Injury of Patella: A Case Report","volume":"6","author":"Sivakumar","year":"2016","journal-title":"J Orthop Case Rep"},{"key":"2025081321100800000_18.8.e266185.12","first-page":"47","article-title":"Solitary Presentation but Multiple Etiologies in Foot: A Case Series","volume":"8","author":"Srinivasalu","year":"2018","journal-title":"J Orthop Case Rep"},{"key":"2025081321100800000_18.8.e266185.13","first-page":"80","article-title":"Foreign Body Induced Osteomyelitis in the Hand - Commonly Missed Clinical and Radiological Diagnosis","volume":"11","author":"Regmi","year":"2021","journal-title":"J Orthop Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T04:10:19Z","timestamp":1755144619000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,13]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2025-266185"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266185","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}