Tattoo-Induced Skin “Burn” During Magnetic Resonance Imaging in a Professional Football Player

The authors present the case of a professional football player with an immediate and sustained cutaneous reaction ("burn") at the site of lower extremity tattoos that occurred during magnetic resonance imaging of the pelvis. The burn was attributed to an electromagnetic reaction due to the ferromagnetic metallic compounds found in tattoo pigments, especially iron oxide-a reaction that has the potential to distort the field of image. These compounds can theoretically create an electric current that increases the local skin temperature, enough to cause a cutaneous burn. "At risk" tattoos are those with black pigment or any other pigments containing iron oxide, as well as those with a design that displays loops, large circular objects, or multiple adjacent points. Patients who develop this reaction may be treated prophylactically or symptomatically with a cold compress to assist with completion of the examination. Alternatively, a towel or cloth may be placed between the cutaneous body parts in those patients who experience the typical reaction resulting from an electrical arc between 2 separate cutaneous tattoos. This is likely an underreported issue that merits mention in the sports medicine literature given the frequent occurrence of cosmetic tattoos in athletes requiring magnetic resonance imaging to diagnose a musculoskeletal injury. As in the present patient, no permanent sequelae have been noted in the literature. Therefore, patients who develop this reaction should be reassured that the reaction is only temporary.