When it comes to a foreign body, I am more likely to get a CT than plain xrays or ultrasound, especially if (1) I don’t know what the foreign body may be, (2) I don’t know where it is, or (3) it’s in an important part of the body.
(1) If I don’t know what the foreign body is, then I don’t know whether it will show up on an xray. (2) If I can’t feel the foreign body, I need a CT to help me locate it. Location helps you decide whether intervention is needed. (3) Is it next to the carotid? Did it hit the femoral vein? It’s difficult to tell on ultrasound and impossible to tell on plain films most of the time.
A CT was done. I was surprised. Needless to say, the CT is inconsistent with the story. The patient was shot with a nail gun. Nails don’t go into your face otherwise. The nail did not hit anything important. It was removed under local anesthesia in the ED. If you can feel the foreign body with your finger, it’s usually easy to take it out.