Role of Ultrasound in the Diagnosis of Common Soft Tissue Lesions of the Limbs

Objective: The objective of this study was to investigate the role of ultrasound in the diagnosis of the soft tissue lesions of the limbs. Methods: Database of the soft tissue lesions of the limbs were reviewed retrospectively. All lesions had been confirmed by histopathology after surgical removal or biopsy. Ultrasound examination of the patients was performed by 4 sonologists with 9 to 22 years of experience, and the results were reviewed by 2 sonologists in panel. Categories and characteristics of some soft tissue lesions of the limbs were studied. Concordance rate was calculated, and reasons of misdiagnosis were analyzed. Results: The patients consisted of 224 males and 173 females, and the age range was 6 months to 74 years (mean, 29.1 +/- 27.3 years). The soft tissue lesions of the limbs included granuloma, inflammatory lesions, hematoma, hemangioma, neurofibroma, lipofibromatous hamartoma, fibrosarcoma, lymphangioma, liposarcoma, Baker cyst, epidermoid cyst, angiolipoma, fibrolipoma, malignant schwannoma, dermoid cyst, and intramuscular myoma. Fibrous tumor, lipoma, and hemangioma are of higher proportion. Baker cyst and neurofibroma were more often diagnosed correctly. Malignant lesions liposarcoma and malignant schwannoma were all misdiagnosed. A large number of misdiagnosed lesions were misdiagnosed as fibroma or lipoma. The overall concordance rate of sonographic diagnosis was 57.7%. Conclusions: Of the soft tissue lesions of the limbs, Baker cyst and neurofibroma are more often diagnosed correctly, and definitive diagnosis of other lesions is challenging. The overall concordance rate of sonographic diagnosis is not satisfactory.