Orbital Foreign Body Detected During Routine Screening for Magnetic Resonance Imaging (MRI) Examinations: A Case Report to Underscore Safety Protocols and Also the Need for Role Extension of Radiographers in Zambia

Abstract

Magnetic resonance imaging (MRI) is a valuable imaging modality for the diagnosis and planning of treatment of diseases and injuries. Although MRI does not use ionising radiation, the examination has safety concerns due to the strong magnetic field that can attract metallic materials from individuals entering the MRI imaging room. It is important to screen patients for possible metallic materials that can be found outside and inside the body before an examination. This is done through the administration of the MRI safety questionnaire to patients. For patients suspected of a metallic intra-orbital foreign body (IOFB), orbital projections are required as part of the screening process. Subjecting a patient with an IOFB to MRI examination is risky; the magnetic field can cause the metal fragment to move which causes injury to soft tissue (even causes blindness). We report an IOFB detected during a routine MRI safety screening of a metalwork teacher referred for a brain scan. This case also highlights the importance of undertaking two occipital-mental (Waters) projections with an upward and then downward gaze. We underscore the need for role extension for radiographers that includes interpretation and reporting on radiographic images to fill the gap created due to the critical shortage of radiologists in the country.