Ultrasound Evaluation of Soft Tissue Masses and Fluid Collections

Abstract

Musculoskeletal ultrasound has utility as a first-line screening modality in the evaluation of soft tissue masses. The sonographic appearances of cysts or lipomas may be sufficient to obviate the need for further imaging. For other complex cystic or solid masses, ultrasound is an inexpensive, widely available imaging modality that can evaluate lesion vascularity, guide diagnostic and therapeutic aspiration or biopsy procedures, and be used for follow-up examinations to determine response to therapeutic interventions.

Application of Ultrasound and Ultrasound-Guided Intervention for Evaluating Elbow Joint Pathologies

“…Increased echogenicity is generally observed in association with acute hematoma, whereas subacute and chronic hematomas usually exhibit hypoechoic changes and are sometimes liquefied and identified as cystic lesions [34].…”

“…7) [35]. Other nonneoplastic masses in the elbow include granuloma annulare and foreign bodies [34]. The appearance of reactive masses cannot usually be differentiated from other neoplastic masses.…”

“…The sonographic features include elliptical or ovoid shapes, as well as avascular, compressible, and well-defined masses with internal hyperechoic linear striations that are parallel to the skin and located in the subcutaneous tissue or intermuscular and intramuscular areas. The sonographic appearance of a lipoma is usually sufficient for a diagnosis, but a large mass with heterogeneous components and increased vascularity may indicate a liposarcoma [34]. Angiolipoma is a variant of a lipoma that appears as a homogeneously echogenic solid mass [35].…”

“…Other benign neoplastic masses in the elbow include vascular lesions (hemangioma and lymphangioma), myxoma, and fibromatosis. High-flow hemangiomas can be detected using Doppler ultrasound with pulsatile arterial flow, but low-flow lesions usually lack the necessary signals [34,35]. Myxomas result from excessive mucin production by fibroblasts.…”

“…However, these findings are nonspecific, and a biopsy is required for a histopathological confirmation. Under the guidance of an ultrasound, a biopsy can be accurately performed in regions of increased blood flow rather than regions of central necrosis [34].…”