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August 7, 1981

Gas in Soft Tissues of Forearm in an 18-Year-Old Emotionally Disturbed Diabetic

Author Affiliations

From the University Hospital (Dr Kusumi) and Division of Infectious Diseases (Dr Plouffe), The Ohio State University, Columbus.

JAMA. 1981;246(6):679-680. doi:10.1001/jama.1981.03320060081028

History  An emotionally disturbed 18-year-old diabetic woman was admitted to the hospital because of a "sore" on her right forearm of ten days' duration, for which she had been taking erythromycin estolate orally in addition to local cleansing of the infected area with hydrogen peroxide. Physical examination showed a 3×3-cm noninflamed ulcer on the volar aspect of the right forearm. Crepitation was detected along the right upper extremity. Vital signs were normal.A roentgenogram of the right forearm demonstrated the typical stigmata of gas in the soft tissues of the forearm. A metallic foreign body suggesting the tip of a needle is observed in the soft tissues near the wrist (Figure).

Diagnosis  Gas in soft tissues of forearm due to self-injection of air.

Comment  The patient had a history of psychiatric problems. Although she irrigated her wound of the forearm with hydrogen peroxide, she admitted to injecting air into the