A study on evaluation of superficial soft tissue masses in extremities using high resolution ultrasonogram with histopathological correlation

Background: To determine sonologically the nature of superficial swellings in extremities using high resolution ultrasonogram with histopathological correlation.
Objective: 1.To evaluate the diagnostic accuracy of ultrasound in assessing superficial musculoskeletal soft-tissue swellings by correlating with their histopathological results. 2. To review normal appearance of superficial soft tissue swellings and to recognize the tumors that cause diagnostic difficulty. 3. To highlight the spectrum of superficial soft-tissue tumors encountered in clinical practice.
Materials and Methods: A prospective observational study was conducted over a period of one year on 52 patients with superficial soft tissue swelling in extremities. These patients were subjected to High resolution ultrasonogram in our institution and the lesions were analysed with respect to size, shape, margins, plane of location, echotexture, consistency, septation, calcification and vascular pattern. A provisional diagnosis was made after Ultrasonogram examination and these findings were correlated with the final histopathological results.
Results: High resolution ultrasonogram had an overall accuracy of 78.8% in identifying superficial soft tissue masses concordant with final diagnosis. Commonly encountered lesions were abscess, hematoma, lipoma, vascular malformation, epidermoid cyst and neurofibroma in our study. Rare lesions like vascular leiomyoma, pilomatricoma, Morel lavelle lesion and granuloma annulare were also encountered. Three malignancies were accurately diagnosed as malignant lesions, with histopathologic discordance in only one among them.
Conclusion: High resolution ultrasonogram is a valuable first line modality of choice in determining the nature of superficial soft tissue swellings.