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Hemangioma. Color Doppler image reveals a highly vascular mass consistent with capillary hemangioma at the superolateral margin of the right orbit.
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Improved developments in digital ultrasound technology and the use of high-frequency broadband transducers make ultrasound (US) imaging the first screening tool in investigating superficial tissue lesions. US is a safe (no ionizing radiation), portable, easily repeatable, and cheap form of imaging compared to other imaging modalities. US is an exce...
Citations
... Vascularity also provides extremely helpful clues to further characterize a lesion. Tumor vascularity correlates with the degree of neoangiogenesis, while absence of detectable flow is usually observed in benign lesions; however, hyperemia or presence of flow is not a constant feature of all malignant tumors [4]. Perilesional hyperemia can be a helpful sign to detect inflammation. ...
Ultrasound (US) is the imaging modality of choice for evaluation of superficial palpable lesions. A large proportion of these lesions have characteristic sonographic appearance and can be confidently diagnosed with US without the need for biopsy or other intervention. The Society of Radiologists in Ultrasound (SRU) recently published a Consensus Conference Statement on superficial soft tissue masses. The goal of this manuscript is (a) to serve as a sonographic pictorial review for palpable lesions based on the SRU statement, (b) present the typical sonographic features of palpable lesions that can be confidently diagnosed with US, and (c) provide an overview of other palpable lesions with a framework to interpret the US studies and advise on appropriate further management.
... It can detect cysts, masses, or foreign bodies around the shoulder joint, contributing to pain, restricted mobility, or other symptoms. Ultrasound identifies and characterizes these soft tissue anomalies, aiding in developing appropriate treatment plans [71]. ...
Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.
... The MRI further confirmed this, which portrayed the extent of the subcutaneous edema in the dorsum, medial, lateral, and posterior aspects of the leg. Together, these diagnostic procedures provided the crucial evidence required for the physician to diagnose the patient with right lower limb lymphedema, signaling the start of a therapeutic journey that promised hope and restoration [4]. ...
Chronic lower limb lymphedema is a challenging and often debilitating medical condition characterized by the abnormal accumulation of lymphatic fluid in the extremities, leading to persistent swelling and discomfort. While this condition can be caused by various underlying factors, early diagnosis, and appropriate management are crucial for improving the patient's quality of life. This case report presents the successful surgical management of chronic lower limb lymphedema in a 30-year-old male patient who had been grappling with this condition for a decade. The patient's journey from the onset of symptoms, including swelling and difficulty in walking, to the eventual diagnosis and treatment is documented herein. Despite seeking medical care from allopathic and homeopathic sources, the patient's condition continued to deteriorate over the years, underscoring the complexity of chronic lower limb lymphedema and its challenges in clinical management. This case highlights the importance of accurate diagnosis, multidisciplinary evaluation, and a comprehensive surgical approach in addressing the complexities of chronic lower limb lymphedema. It also sheds light on the potential complications that may arise during treatment and the postoperative care required to achieve a favorable outcome. By sharing this case, we aim to contribute to understanding this condition and provide insights into the effective management of chronic lower limb lymphedema.
... As ultrasound ruled out ganglion cyst, myxoma, angiolipoma, and intraneural lipofibroma, we did not feel the need to do any further investigation. USG due to its ability to localize a lesion, determine whether lesion is cystic or solid, ability to show real time vascularity, dynamic study, cheap, and easy availability, of is investigation of choice after routine X-rays to rule out spaceoccupying lesion in wrist, leading to secondary CTS [13]. Ultrasound being 86.8% sensitive and 95.5 % specific in diagnosing soft-tissue lipomas unless ultrasound findings are not confirmatory further investigations may not be performed [14]. ...
Introduction:
Lipomas are most common soft-tissue tumors but rarely are found to be symptomatic. <1% of lipomas are found in hand. Subfascial lipomas can cause pressure symptoms. Carpal tunnel syndrome (CTS) can be idiopathic or secondary to any space-occupying lesion. Triggering usually occurs due to inflammation/thickening of A1 pulley. Most have reported a lipoma in distal forearm or near median nerve, leading to triggering of index or middle finger and carpal tunnel symptoms. All the cases reported had either an intramuscular lipoma in flexor digitorum superficialis (FDS) tendon slip of index or middle finger, with or without accessory belly of FDS muscle or a neurofibrolipoma of the median nerve. In our case, the lipoma was under palmer fascia, in flexor digitorum profundus (FDP) tendon sheath of fourth finger causing triggering of the ring finger and CTS symptoms in flexion of the ring finger. Hence, this is a first report of this kind in the literature.
Case report:
We hereby report a one of its kind case in which a 40-year-old Asian male patient had triggering of the ring finger with associated intermittent CTS symptoms, on making a fist, secondary to space-occupying lesion in palm, which was diagnosed by ultrasound as lipoma in FDP tendon of the ring finger in palm. This lipoma was surgically removed by AO ulnar palmer approach and carpal tunnel was decompressed. Histopathology report confirmed the lump to be fibrolipoma. The patient had complete relief of symptoms postoperatively. At 2 years follow-up, there was no recurrence.
... Ultrasonography could be considered the best method to evaluate lymph nodes and soft tissue in the suspect of lymphoproliferative disease, due to its high speci city and accurancy in the study and characterization of normal and pathological aspects [3]. Doppler ultrasound examination is important in the de nition of vascolarization of new nding lesions in the soft tissue, especially if there are suspects for a tumoral disease or there is need for differential diagnosis between cystic and solid lesions [4,5]. Futhermore, Doppler ultrasound of the extremities allows to rule out vein thrombosis and arterial stenosis or occlusions, complications that may be associated with malignant diseases, like lymphoma, and that could be life threatening [6,7]. ...
An 80-year-old woman presented to the hospital with a 11-month history of swelling that progressively involved the whole left upper limb. Her clinical history was rilevant for arterial hypertension, obesity and rheumatoid arthritis. Ultrasonography revealed hypoechoic nodules in soft tissue of the left arm,brachial vein thrombosisandmalignant left axillary lymphadenopathy. The patient started antithrombotic therapy and underwent axillary lymph nodes excisional biopsy: a diagnosis of diffuse large B-cell lymphoma was made and she was referred to hematology clinic for chemotherapy. At a 3-month follow-up visit, the patient showed decrease of the swelling of her upper limb; the ultrasonographic control demonstrated reduction in size and number of soft tissue nodules and resolution of vein thrombosis.
... Ряд авторов считают типичным наличие тонкой капсулы в эхографической картине липом [8], отмечают, что липомы -прежде всего инкапсулированные образования [9], сообщают о гипоэхогенности капсулы [10]. Однако, нам представляется более прием лемой расширенная в отношении капсулы трактовка разнообразия ультразвуковых проявлений липом [11]. ...
Data of echography of 210 verified on the operation and in histological research lipomas, including 182 (86.7 %) encapsulated and 28 (13.3 %) diffuse. Four possible rims along the periphery of the formations have been identified. The morphological nature of these acoustic manifestations and the frequency of their occurrence have been determined. Elastography did not improve its differentiation by showing the boundaries of formations more clearly.
... A hematoma is a collection of blood products outside of blood vessels and can occur following trauma, with anticoagulation medication, from surgery, or in hemorrhagic tumors. 1 The patient often presents with an enlarging soft tissue mass that can be painful. Hematomas can have a complex appearance on imaging, which depends on the age of the blood products; however, a key feature of hematomas is the lack of internal vascularity which can help distinguish it from a true neoplasm. ...
Soft tissue lesions are commonly encountered and imaging is an important diagnostic step in the diagnosis and management of these lesions. While some of these lesions are true neoplasms, others are not. These soft tissue tumor mimickers can be due to a variety of conditions including traumatic, iatrogenic, inflammatory/reactive, infection, vascular, and variant anatomy. It is important for the radiologist and clinician to be aware of these common soft tissue tumor mimickers and their characteristic imaging features to avoid unnecessary workup and provide the best treatment outcome.
... Ultraschall in der diagnostischen und präoperativen Beurteilung solider und zystischer, nicht entzündlicher, gutartiger Hautläsionen Ultraschall lässt eine In-vivo-Identifizierung der Art (sub) kutaner Läsionen (fest, zystisch, flüssig) sowie ihre Beziehung zu den umgebenden Strukturen zu. Die häufigsten gutartigen Läsionen im dermatochirurgischen Bereich sind Lipome, Zysten, entzündliche Läsionen (Abszesse), Serome und Hämatome (separat beschrieben), die von anderen potenziell bösartigen Läsionen differenziert werden müssen [53]. Tabelle 2 illustriert die typischen sonographischen Merkmale der am häufigsten vorkommenden Zysten und Lipome sowie die relevanten bereitgestellten operationsrelevanten Informationen. ...
... Abszesse, lokalisierte Eiteransammlungen, die hauptsächlich durch bakterielle Infektionen verursacht werden, erscheinen im Ultraschall meistens als runde, heterogene Flüssigkeitsansammlungen mit mehreren zentral lokalisierten Echos, während der Farbdoppler eine erhöhte Vaskularisation in der Peripherie der Läsion zeigt (wichtiges Unterscheidungsmerkmal zwischen einem Abszess und einem Hämatom) [53]. Häufig kann ein periläsionales Weichteilödem beobachtet werden. ...
Zusammenfassung
Die Sonographie ist ein modernes bildgebendes In‐vivo ‐Verfahren, das in der Dermatologie zunehmend als ergänzendes Instrument zur klinischen Untersuchung und Dermatoskopie eingesetzt wird. Bei höheren Frequenzen (≥ 15 MHz) ist die Ultraschalldiagnostik eine etablierte Methode zur Beurteilung gutartiger und bösartiger Hautläsionen, lokoregionärer Lymphknoten, Überwachung der therapeutischen Wirksamkeit bei verschiedenen entzündlichen Hauterkrankungen und zur Patientennachsorge. Ein Bereich, der zunehmend von leistungsfähigen, bildgebenden Verfahren wie den Ultraschallsystemen profitieren könnte, ist die Dermatochirurgie. Die präoperative sonographische Darstellung von Hauttumoren, entzündlichen Hauterkrankungen (zum Beispiel Akne inversa, Abszesse) oder unterschiedlicher Nageltumoren liefert dem Chirurgen relevante präoperative Informationen und eine genaue anatomische Zuordnung für eine optimale chirurgische Planung. Zudem ermöglicht es die Identifizierung von potenziell komplexen Aspekten, die bei einer OP‐Planung berücksichtigt werden müssen, welche manchmal ein interdisziplinäres Vorgehen erfordern könnten. Dies kann unnötige operative Schritte vermeiden und somit die Patienten‐Compliance erhöhen.
In dieser Übersicht diskutieren wir die zunehmende Bedeutung der Ultraschalldiagnostik in der Dermatochirurgie sowie das Spektrum der Hauterkrankungen, bei dem die präoperative Sonographie eine präzisere, individuellere Operationsplanung zur besseren Beratung unserer Patienten ermöglicht.
... US in the diagnostic and preoperative evaluation of solid and cystic non-inflammatory benign skin lesions US can identify in vivo the nature of (sub)cutaneous lesions (solid, cystic, fluid, etc.) and their relationship to the surrounding structures. The most common nontumoral benign lesions in the dermatosurgical field are lipomas, cysts, inflammatory lesions (abscesses), seromas, and hematomas (described separately), which need to be differentiated from other potentially malignant lesions [53]. Table 2 illustrates the characteristic sonographic features of the most commonly encountered cysts and lipomas, as well as the surgery-relevant information provided by US. ...
... Abscesses, localized collections of pus, mainly caused by bacterial infections, usually present on ultrasound as round, heterogeneous fluid collections with multiple centrally located echoes, while Color Doppler shows an increased vascu-larization in the periphery of the lesion (significant feature differentiating an abscess from a hematoma) [53]. Often, perilesional soft tissue edema presenting as cobblestoning surrounding the abscess can be observed. ...
Ultrasonography (US) is a modern, in vivo imaging method, which is increasingly being used in dermatology as a complementary tool to clinical examination and dermoscopy. At higher frequencies (15 MHz and above), US is an established method for assessing benign and malignant skin lesions, locoregional staging, monitoring the therapeutic efficacy in various inflammatory skin conditions, and patient follow‐up. One field, which may increasingly benefit from performant imaging techniques such as US is dermatologic surgery. Preoperative imaging of cutaneous tumors, inflammatory skin conditions (hidradenitis suppurativa, abscesses, etc.), or nail pathology provide dermatologic surgeons with relevant information for an optimal surgical planning, identifying potential complex aspects which might require interdisciplinary approaches, herein sparing unnecessary surgical interventions and increasing patients' compliance. In this review, we discuss the increasing significance of US in the field of dermatologic surgery, as well as the spectrum of cutaneous pathology where sonography can aid in the preoperative setting to provide a more precise, individualized surgical planning for better counseling to our patients and improved surgical results.
... Cystic nature of the lesion can be determined with a high-frequency transducer ultrasound (US). Internal vascularization of the lesion may be demonstrated with color Doppler imaging (8). Magnetic resonance imaging (MRI) with its superior contrast and spatial resolution should be the preferred imaging method in diagnosis and characterization of hand and wrist mass lesions. ...
... Phleboliths may be seen as bright echogenic foci with posterior acoustic shadowing inside the lesion. On color Doppler US, hypervascularity may be detected in hemangiomas (8,29). On MRI, hemangiomas are typically iso to hypointense compared to muscle on T1weighted sequences and have high signal intensity on T2weighted sequences due to increased fluid content secondary to slow blood flow in vessels ( Figure 7) (32). ...
... On US, they appear usually as homogeneous solid mass lesions with or without a capsule and are predominantly hyperechoic or isoechoic compared to surrounding fat tissue. On Doppler US, they show no vascularity or show minimal vascularity (8). On MRI, lipomas have the similar MRI signal pattern as the subcutaneous fat tissue. ...
