This week's challenging case was donated by Dr. Emily Hall. The patient is a previously-healthy toddler who began acting unusually fussy and refused to ambulate. Examination reviewed a thin black object under the skin of her right foot. Extraction was unsuccessful and the child was playing and ambulating at the end of the visit and was therefore sent home. The child was brought back the following day because the object had moved approximately 3 cm within a 24 hour period in the semilunar pattern shown in the image below:
The image is shown with permission from the mother.