X-ray of the front (A) and side (B) of a patient's left knee. The lines are thin gold threads. (Image courtesy of The New England Journal of Medicine ©2013.)
Patient: 65-year-old woman from South Korea.
Symptoms: The patient had previously been diagnosed with osteoarthritis of the knee, a degenerative disease that causes pain and stiffness. She had previously sought medical attention and was treated with painkillers and nonsteroidal anti-inflammatory drugs. She had also previously received steroid injections directly into her knees, but the pain persisted.
Then the medications started giving her severe stomach pain, so she stopped taking them completely.
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What happened next: The woman decided to look for alternative treatments for her joint pain and began weekly acupuncture. When the pain became particularly severe, she increased the frequency to several sessions a week.
She later went to the hospital because of severe pain in her knees. An X-ray of her left knee showed that the tibia on the inside of the joint had thickened and hardened. In addition, there were bone growths called spurs on the inside of the tibia and femur near the knee joint.
Doctors also saw hundreds of dots on the X-ray around the knee joint that turned out to be tiny gold threads.
Diagnosis: Doctors determined that the threads had been inserted into the woman during acupuncture sessions. These short, sterile gold threads had been intentionally left in the tissue to provide continuous stimulation.
Treatment: Doctors did not say whether the patient had the gold threads removed, but in previous cases the threads were left in place.
Leaving the threads in place is not safe as this has led to cysts in the past.
What makes this case unique: Doctors wrote in her case report that gold thread acupuncture is widely used in Asia to treat osteoarthritis and rheumatoid arthritis. However, there is no evidence that the practice is effective, and some cases suggest that it may indirectly worsen arthritis by preventing people from receiving adequate and timely treatment.
For example, in another case, a 58-year-old woman from South Korea underwent gold thread acupuncture to relieve wrist pain caused by rheumatoid arthritis. By the time she sought medical help, her condition had become particularly severe, and doctors believed that the disease had progressed so far because she had not started taking anti-rheumatic drugs early enough and had instead turned to alternative medicine.
OTHER DILEMMAS
—Diagnostic dilemma: A man delayed a sneeze and it pierced his trachea.
—Diagnostic dilemma: A botched penis tattoo leaves a man with a permanent semi-erection.
—Diagnostic dilemma: A fish bone passed through a man's abdomen and pierced his liver.
In addition, the threads can migrate inside the body, and their fragments can damage adjacent tissue. For example, gold threads implanted in the back of a 75-year-old South Korean woman migrated to her right shin over 10 years, causing cellulitis, a deep skin infection.
In their report on the knee case, doctors noted that gold threads inserted during acupuncture could make X-rays difficult to read.
Others warn that these embedded gold threads make it difficult for people to undergo MRI scans because of the risk of the metal shifting and damaging an artery.
In this regard, doctors note that health care workers should be aware of the potential risk factors associated with gold thread acupuncture. However, the fact that they are easily detectable on X-rays allows their location to be tracked over time if necessary.
Disclaimer
This article is for informational purposes only and does not provide medical advice.
Sophie Berdugo, Social Link Navigator, Live Science Contributor
Sophie is a UK-based staff writer for Live Science. She covers a wide range of topics, having previously covered research on everything from bonobo communication to the first water in the universe. Her work has also appeared in New Scientist, The Observer and BBC Wildlife, and her freelance work for New Scientist was shortlisted for the 2025 ASBJ Newcomer of the Year award. Before becoming a science journalist, she earned a PhD in evolutionary anthropology from Oxford University, where she spent four years studying why some chimpanzees are better at using tools than others.
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