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Body Art Causing Radiological Artifact
Abstract Number: 178
Abstract Type: Case Report/Case Series
An otherwise healthy 26-year-old pregnant woman in labor requested epidural analgesia. Her history was significant for scoliosis, having undergone surgical correction with Harrington rods in the thoracic spine 10 years earlier. A well-healed midline surgical scar was apparent between her scapulae. The lumbar area of the back was free of any obvious surgical scars. She offered spine radiographs, taken 5 yrs earlier, to confirm location of surgical hardware. Examination of the radiographs raised concern for possible lumbar spinal instrumentation, which could potentially complicate the epidural anesthetic. On further questioning, it was a dangling navel jewelry. Epidural analgesia for her labor proceeded without difficulty.
The popularity of body art has increased in prevalence over recent years with some data suggesting 25-50% of the population with some form of body art, either piercings (other than ear) or tattoos(1). Body art is particularly becoming more common in women of childbearing age; hence clinicians need to be aware of the implications. Some concern has been raised about inserting neuraxial anesthesia needles through lower back tattoos, but this fear seems to be unfounded, as tattoo ink remains fixed in the macrophages of the skin and does not travel along the track of an inserted needle (2,3). Body piercings in the oral cavity could have airway complications, thus oral jewelry is best removed during labor. Nipple, navel, and genital piercings can have obvious obstetrical or lactation consequences in the peripartum period. In this case, with the confounding history of thoracic Harrington rod surgery, navel jewelry created a radiological image easily confused with surgical spinal hardware.
1. Laumann AE, et. al., J Am Acad Derm 2006;55:423-21
2. Mavropoulos A, Camann W. IJOA 2009; 18: 98-9
3. Sperry K. Administering regional anesthesia to parturients with lumbar tattoos. SOAP Newsletter, Summer 2001