Woman's knee pain was caused by gold threads in her joints left behind by acupuncture

A 65-year-old woman in South Korea sought help for severe knee pain. Hospital X-rays showed hundreds of tiny gold threads surrounding the joint. The threads were intentionally left in place during gold-thread acupuncture, a technique that implants metal to extend stimulation.

Her case raises practical concerns about safety, evidence, and how embedded metals can complicate routine imaging.

In a clinical image case, radiographs showed thickened inner shin bone and prominent bony spurs near the joint.

Here subchondral sclerosis, hardening just below joint cartilage, appeared with narrowing of the medial joint space.

The images also revealed numerous radiodense strands clustered around the knee. Those lines are radiodense, bright on X-rays because metal strongly blocks the beam.

The work was led by Wan-Hee Yoo, M.D., at Chonbuk National University. His research focuses on rheumatology and imaging in arthritis.

Gold threads add visual clutter that can mask edges used to judge wear and alignment. That can make precise grading of osteoarthritis, chronic joint cartilage loss that causes pain and stiffness, more challenging in busy clinics.

Gold thread acupuncture

Gold thread acupuncture implants short sterile wire segments through standard needles and leaves them in soft tissue. The goal is constant stimulation without repeated needle sessions during flares.

“It has been hypothesized that gold thread implanted at the acupuncture points acts as a continuous acupuncture stimulation,” wrote  Yoo. The statement reflects how practitioners expect the metal to keep sending a mechanical signal.

The method is offered in parts of East Asia for joint pain and swelling. It differs from routine acupuncture, needle insertion at mapped points to reduce pain, because it leaves a lasting foreign body behind.

Because the metal stands out on X-rays, physicians can follow thread position over time if needed. That visibility helps when deciding whether a foreign body, any material that is not native to the body, has shifted or is stable.

Issues with gold thread acupuncture

Reports describe thread fragmentation, migration, and tissue damage in a minority of patients, with one open-access study documenting recurrent infection in the lower leg after prior back implantation.

The authors hypothesized that fragments traveled over years, seeding a site that later inflamed.

In that case, the patient developed cellulitis, a deep skin infection that spreads rapidly through soft tissues. Radiographs of the leg showed many threads embedded in the area that hurt and swelled.

Another clinical report described extensive gold threads in the wrists and hands of a woman with long-standing rheumatoid disease. The disease had progressed by the time specialist care began after earlier reliance on thread implantation.

The cautionary theme is delay. When people depend on unproven implants, they can miss timely disease-modifying treatment, medicines that slow or halt immune attack on joints, in conditions like rheumatoid arthritis.

What doctors consider before MRI

Magnetic scanners interact with metal, so screening is standard before imaging. An evaluation found that gold and certain stainless steel acupuncture needles were MR compatible under test conditions, and did not heat in those tests.

Policies still vary because safety depends on exact composition, length, and location. A safety listing notes 24k gold sutures as MRI conditional, which means scanning proceeds only when specific conditions are met.

Even when scanning is allowed, metal can distort images by creating artifacts that hide soft tissues. That distortion can limit how well radiologists assess cartilage, synovium, the thin lining that normally lubricates joints, or nearby vessels.

For many patients, X-ray tracking remains the simplest way to monitor thread position. Ultrasound can also help map superficial strands without exposure to radiation.

Gold thread acupuncture lessons

The visible threads tell two stories at once, one about pain and one about choices. People often turn to alternatives when standard nonsteroidal anti-inflammatory drugs, medicines that reduce pain and swelling, cause stomach upset or stop helping.

Major guidelines for knee osteoarthritis emphasize exercise, weight control, and topical or oral NSAIDs, medicines that reduce inflammation and pain by blocking certain body chemicals, with steroid injections during flares.

They conditionally consider acupuncture for some patients, but they do not evaluate implanted gold threads as a recommended option.

Evidence for gold-thread implantation remains thin and case-based. Without controlled trials, it is hard to weigh benefits against risks like migration, infection, imaging artifacts, and the possibility of delayed definitive care.

Patients deserve clear information about how a permanent implant could affect future tests or therapies. Discussing plans with a clinician before any procedure helps match goals to treatments with known safety profiles.

This woman’s images are striking, yet the lesson is simple. Relief is the goal, but the path should keep options open for scans, surgery, and proven medicines if they become necessary.

The study is published in The New England Journal of Medicine.

—–

Like what you read? Subscribe to our newsletter for engaging articles, exclusive content, and the latest updates. 

Check us out on EarthSnap, a free app brought to you by Eric Ralls and Earth.com.

—–