Numerous linear metallic densities on radiograph: Gold threads.

A 75-year-old woman with recurrent bladder cancer was transferred to our department for palliative treatment. Plain radiographies of the chest and kidney-ureter-bladder (KUB) [Figure 1a and b] showed lots of linear foreign materials that appeared to be uniform in size, shape, and density. A computed tomography (CT) of the abdomen and pelvis demonstrated multiple fine linear metallic subcutaneous densities along the anterior and posterior [Figure 1c] abdominal walls, which were compatible with the findings on the KUB. Further history taking revealed that the patient had received acupuncture therapy with gold thread for more than 10 years in the course of chronic musculoskeletal pain treatment. The linear densities correspond to implanted gold threads at the acupuncture points. Acupuncture, one of the most popular modalities in complementary and alternative medicine, is often used for pain treatment. Practitioners insert small pieces of sterile gold thread into the painful areas of the body in the course of acupuncture therapy. These short gold-needle fragments are left permanently in the subcutaneous tissues of the patients and may work as continuous acupuncture stimulation.[123] The gold threads could be visible on and complicate imaging studies such as plain radiographs, CTs, and magnetic resonance imaging (MRIs), as seen in our patient.

Figure 1

Lots of linear metallic densities on radiographs. (a and b) Plain radiograph of chest and KUB shows numerous linear radiodense threads. (c) Computed tomography of the abdomen and pelvis shows multiple linear metallic subcutaneous densities along the posterior abdominal wall (coronal)