Intra-articular Migration of a Broken Needle in an Intravenous Drug User: A Case Report and Surgical Management

Intravenous drug users (IVDUs) frequently present with complications; however, intra-articular migration of a broken needle is exceedingly rare. This is the case of a 29-year-old male heroin user who experienced needle breakage during self-injection into the popliteal fossa. The initial removal attempts failed, and he presented with knee discomfort 10 days later. Radiographs revealed a metallic foreign body in the popliteal fossa, near the femur. Posterior surgical exploration failed to locate the needle. Intraoperative imaging showed anterior migration. A medial parapatellar arthrotomy was performed, and the needle was retrieved between the anterior cruciate ligament (ACL) and the lateral meniscus. This case highlights the importance of intraoperative imaging and surgical flexibility. Early diagnosis and retrieval are crucial for avoiding joint damage and complications.