10yM who came to the ED after being shot by a bb gun.  He had no entry wound but did have swelling over his right forearm and thigh.  Below looks like there could be a foreign body under the skin but this is actually Subcutaneous Emphysema!

Before you say it…Subcutaneous emphysema, strictly speaking, refers to air in the subcutaneous tissues.  But the term is generally used to describe any soft tissue emphysema of the body wall or limbs.  The patient had such a force from the bb gun that air was ‘injected’ into the skin causing localized trauma with posterior shadowing.  As there was no actual entry wound no foreign body was suspected.