Migration of Spinal Hardware Into the Popliteal Vein

CASE: A 41-year-old woman with prior T12-L4 instrumentation for adolescent lumbar scoliosis presented with left posteromedial thigh pain initially diagnosed as an adductor strain. Two years later, she re-presented with knee stiffness, lower leg mottling, and paresthesia suspected to be reflex sympathetic dystrophy. Radiographs later revealed a 13.6-cm radiopaque object in the popliteal fossa and rod absence from the lumbar spine. The spinal rod was removed from the popliteal vein by orthopaedic surgery. CONCLUSION: Radiographs are an easily obtained, low-cost, and high-yield resource that are integral to workup of musculoskeletal pain, especially in patients with orthopaedic implants.