Accuracy of High-Resolution Ultrasound for Evaluating Soft Tissue Tumours of the Hand and Wrist

Abstract

Objectives: High resolution ultrasound (HRUS) is increasingly popular in the assessment of soft tissue tumours. This retrospective study evaluates the reliability of HRUS in diagnosing soft tissue tumours of the hand and wrist, compared to clinical evaluation, intraoperative findings and histological examination. Methods: Sixty-three patients with soft tissue tumours of the hand and wrist were first evaluated clinically investigated. HRUS was then performed using a 5-17 MHz broadband linear probe, with the radiologist blinded to the clinical interpretation. The patient was scheduled for operation depending upon suspected pathology. Histological examination was routinely obtained during surgery. Results: Thirty-one patients underwent surgery. Of the 16 solid lesions HRUS was right in 15 cases (94%). Only nine of these 16 lesions (56%) were correctly diagnosed on clinical examination (p= 0.041). All 15 cysts were correctly diagnosed by HRUS, whereas clinical examination alone correctly diagnosed a cyst in 14 patients (not significant). Conclusion: No significant difference was found in the differentiation of cystic and solid lesions comparing HRUS and clinical examination. HRUS is significantly better than clinical diagnosis alone in distinguishing the type of solid lesions. Further benefits of HRUS include the identification of atypically localised cysts and improved preoperative planning.