## 1 Introduction
However, the study focused on resource-limited areas and austere settings where portability is a significant factor. For example, hand-held u/s devices today are used in rural Africa, up on Mt. Everest, and this summer, launching into space with NASA; these places would not be as readily feasible with a traditional bulkier and more costly machine. Thus, the study looked at two portable imaging modalities. An MXFI device is small, light, and can easily be taken to the patient's bedside for POCT. Portable ultrasound equipment like the Butterfly iQ used for this research is much less expensive than standard X-ray devices. It allows the clinician to examine the patient at the bedside instead of requiring that the sick or injured patient be transported to the radiology suite. The cost for the latest model of the Butterfly iQ+ is less than $3000 plus the cost of a smartphone or tablet. In contrast, the cost for non-hand-held ultrasound machines is between $40,000 and $100,000. The cost for hand-held X-ray imagers is similar. POCT can involve blood and urine testing as well as imaging. As more Emergency Medicine clinicians gain skills in using POCUS, and as ultrasound devices become smaller, more portable, and less expensive, POCUS is increasingly perceived as a powerful and clinically useful modality for diagnosing and initiating patient treatment at the bedside. For instance, the value of POCUS has been highlighted during the current SARS-CoV-2 pandemic; POCUS has been shown to be able to identify patients with significant and concerning pulmonary involvement at the first point of clinical evaluation, thus permitting rapid triage and initiation of appropriate treatment. In some clinical circumstances, POCUS is now considered the Standard of Care. One of these is in the identification of FBs in wounds [6,10]. POCUS has demonstrated significant efficacy and accuracy in detecting radioopaque and radiolucent FBs in wounds. Several studies have reported that radiolucent objects are poorly visualized by X-ray with sensitivities of less than 10%; some glass and almost all wooden FBs are radiolucent [11,12]. POCUS, employing high-resolution devices, successfully detected wood and thorns with great accuracy. In an analysis of 120 patients with wood and thorns in their wounds, trained practitioners using high-resolution POCUS devices identified wood FBs and thorns with a 94.5% sensitivity and a 53.8% specificity [13]. However, size remained an issue, as larger wooden objects were more easily detected with POCUS; objects smaller than 2.5 mm were often missed [14]. Furthermore, several ultrasound-guided soft tissue foreign body removal techniques have been developed [15, 16, 17, 18]. POCUS continues to evolve with lighter probes offering increased resolution at decreasing prices, thus bringing radiological imaging to remote and extreme environments, such as rural Africa, on top of Mount Everest, Antarctica, and this summer in space with NASA [19, 20, 21]. In 2020, the WHO published several guidelines and handbooks on using portable medical imaging in the context of the COVID-19 pandemic, TB, and pneumonia [22]. Traditional mainstream portable X-ray devices are cumbersome, weighing hundreds to thousands of pounds. In the past few years, the market has seen new innovative, lightweight X-ray devices, including Micro C (Oxos; Atlanta, GA, USA), Maven Handheld (Maven Imaging; Aliso Viejo, CA, USA), and Smart-C (Turner Imaging Systems; Orem, UT, USA). To date, there has not been published peer-reviewed data on these systems. New studies have looked at improving the resolution of traditional X-rays by using dark-field radiography, increasing the detection of FB by a factor of 6 [23]. MFXI has a higher resolution (about 60 \(\upmu\)m) than newer lightweight devices (100-150 \(\upmu\)m). The investigators employed a home-built micro-focus X-ray imaging device with a 10 \(\upmu\)m focus size with an up to 100-fold increased resolution compared to conventional X-ray systems.