Pictorial review: Magnetic resonance imaging of benign soft tissue masses of the hand and wrist

doi:10.1016/S0009-9260(05)83185-X

Clinical Radiology

Volume 50, Issue 8, August 1995, Pages 519-525

https://doi.org/10.1016/S0009-9260(05)83185-X Get rights and content

Magnetic resonance imaging (MRI) is the imaging method of choice for evaluating the presence and extent of soft tissue masses. It is particularly useful for assessing masses in the wrist and hand, where benign lesions predominate. A specific diagnosis may be made, or strongly suspected, from the characteristic MRI features found in certain conditions like ganglion, haemangioma, arteriovenous malformation, giant cell tumour of the tendon sheath and lipoma.

References (20)

KransdorfMJ et al.
Imaging of soft tissue tumors
Radiologic Clinics of North America
(1993)
ArmstrongSJ et al.
Review of the use of MRI in soft tissue lesions
Clinical Radiology
(1992)
SherryCS et al.
MR evaluation of giant cell tumors of the tendon sheath
Magnetic Resonance Imaging
(1989)
ZeissJ et al.
Post-traumatic synovitis presenting as a mass in the suprapatellar bursa of the knee. MRI appearance
Clinical Imaging
(1993)
HermannG et al.
Tumour and tumour-like conditions of the soft tissue: magnetic resonance imaging features differentiating benign from malignant masses
The British Journal of Radiology
(1992)
CrimJR et al.
Diagnosis of soft-tissue masses with MR imaging: can benign masses be differentiated from malignant ones?
Radiology
(1992)
JelinekJS et al.
MR imaging of soft-tissue masses (letter)
American Journal of Roentgenology
(1990)
BerquistTH et al.
Value of MR imaging in differentiating benign from malignant softtissue masses: study of 95 lesions
American Journal of Roentgenology
(1990)
KransdorfMJ et al.
Soft tissue masses: diagnosis using MR imaging
American Journal of Roentgenology
(1989)
MillerTT et al.
Benign soft tissue masses of the wrist and hand: MRI appearances
Skeletal Radiology
(1994)

There are more references available in the full text version of this article.

Cited by (39)

MRI of wrist and hand masses
2015, Diagnostic and Interventional Imaging
Citation Excerpt :
This is also known as a neural fibrolipoma or perineural or intraneural lipoma. It is a rare lesion which presents from childhood onwards and involves proliferation of fatty and fibrous tissues surrounding the nerve, infiltrating the epineuron and perineuron [1,7,8]. It presents with a slowly growing palmar mass on the wrist and forearm.
Hand and wrist masses represent a common diagnostic challenge. They are predominantly due to pseudomasses, which are mostly cysts and to benign masses that include tenosynovial tumors, fibrohamartolipomas, vascular malformations, glomus tumors and epidermal inclusion cysts. Malignant tumors of the wrist and the hand are extremely rare. Magnetic resonance imaging is the imaging technique of choice to characterize and circumscribe lesions to determine the best treatment option.
Ultrasound of wrist and hand masses
2015, Diagnostic and Interventional Imaging
Citation Excerpt :
These are clearly delineated masses consisting of mature adipocytes, which differ little from the surrounding fat. Although a lipoma is the most common soft tissue tumor, only 5% of lipomas of the arm are located in the hand [10] where they are found particularly in the thenar and hypothenar eminences and in the median part of the surface of the palm [11]. Patients are often middle aged (5th and 6th decades) and usually present with a soft consistency, slowly growing soft tissue mass, which is usually asymptomatic.
Giant cell tumors of the tendon sheaths in the hand: Review of 96 patients with an average follow-up of 12 years
2013, Revue de Chirurgie Orthopedique et Traumatologique
Les tumeurs à cellules géantes (TCG) de la main sont relativement fréquentes et de bon pronostic, mais avec un risque de récidive. Le but de l’étude est d’évaluer les résultats cliniques à long terme d’une série consécutive et de déterminer les facteurs de risque de récidives.
Il s’agit d’une étude rétrospective de 96 patients (57 femmes, 37 hommes) opérés entre février 1982 et octobre 2005 d’une TCG des gaines synoviales de la main. L’âge moyen à l’intervention était de 47,7 ans ± 14,5 (13–75). Tous les patients ont été revus par un opérateur indépendant. Ont été notés : le résultat clinique (quick DASH, indice de satisfaction), l’apparition de récidive, l’aspect histologique de la tumeur, sa localisation, les marges d’exérèse et l’envahissement de structures anatomiques adjacentes (tendons, articulation). La localisation tumorale était : index : 29 cas, majeur : 23 cas, pouce : 21 cas, annulaire : 11 cas, auriculaire : 11 cas, région hypothénar : deux cas et thénar : un cas. Il s’agissait dans tous les cas d’une lésion isolée. La tuméfaction était palmaire dans 27 cas, dorsale dans 20 cas et latérale ou médiale dans 59 cas. La localisation articulaire interphalangienne distale était la plus fréquente : 35 %. La tuméfaction était sensible dans 12 cas. Le délai entre l’apparition et la consultation variait d’un mois à sept ans. En préopératoire, était réalisée une radiographie standard associée dans huit cas à une échographie et dans un cas à une résonance magnétique. La taille tumorale était en moyenne de 15,8 mm ± 2,6 (5–30). Sur le plan histologique, on retrouvait une lésion polylobée comprenant des cellules géantes multinucléées avec ou sans capsule.
Le recul moyen à la révision était de 12,1 ans ± 3,8 (5–29). On notait huit récidives : 8,3 % (chez sept patients). Le délai moyen de récidive était de 2,75 ans ± 2 (1–6,5). Dans chaque cas de récidive, on notait : un développement tumoral intra-articulaire et/ou une érosion tendineuse (p < 0,01). On note une complication fonctionnelle : une arthrodèse de l’interphalangienne distale (IPD) sur une des récidives. Le quick DASH moyen à 2,3/100 (0–31).
Les TCG des gaines synoviales de la main restent des lésions bénignes dont le principal risque est la récidive. Elle survient le plus fréquemment dans les 36 mois suivant l’exérèse. Le développement tumoral en intra-articulaire, la résection marginale et l’atteinte tendineuse semblent être des facteurs favorisant la récidive. Nous n’avons pas pu démontrer une corrélation entre le type histologique tumoral (encapsulé ou pas) et cette récidive.
Niveau IV.
Giant cell tumors of the tendon sheaths in the hand: Review of 96 patients with an average follow-up of 12 years
2013, Orthopaedics and Traumatology: Surgery and Research
Citation Excerpt :
Other than providing an opportunity to eliminate differential diagnoses, this will help to discover other lesions such as cortical erosion and subchondral cysts [7,17]. Ultrasonography usually detects a hypoechogenic lesion [18,19], although hyperechogenic have also been described [18,20,21]. MRI shows an low-signal lesion, mostly in the tissue [17,21].
Giant cell tumors (GCT) of the hand are relatively common and have a good prognosis, but the risk of recurrence is high. The goal of this study was to evaluate the long-term clinical results of a consecutive series of patients and to determine the risk factors for recurrence.
This was a retrospective study of 96 patients (57 women, 39 men) operated between February 1982 and October 2005 for GCT of the tendon sheaths in the hand. The average age at the time of the procedure was 47.7 ± 14.5 years (range 13–75). All the patients were reviewed by an independent surgeon. The following were recorded: clinical result (QuickDASH, satisfaction), recurrence, histological appearance of tumor, location of tumor, excision margins and extension into the neighboring anatomical structures (tendon, joint). The tumor was located in the index finger in 29 cases, middle finger in 23 cases, thumb in 21 cases, ring finger in 11 cases, little finger in 11 cases, hypothenar area in two cases and thenar area in one case. In all cases, the lesion was isolated. The swelling was palmar in 27 cases, dorsal in 20 cases and medial or lateral in 59 cases. The most common joint location was the DIP joint (35% of cases). The swollen area was sensitive in 12 cases. The time from the appearance of the tumor to physician consultation ranged between 1 month and 7 years. Before the surgery, standard X-rays were taken in all patients; ultrasonography was also performed in eight patients and MRI in one patient. The tumor had an average diameter of 15.8 ± 2.6 mm (range 5–30). Histological analysis revealed a multilobed lesion with multinucleated giant cells, with or without encapsulation.
The average follow-up at the time of review was 12.1 ± 3.8 years (range 5–29). There were eight recurrences in seven patients (8.3%). The average time to recurrence was 2.75 ± 2 years (range 1–6.5). In every case of recurrence, there had been intra-articular tumor development and/or tendon destruction (P < 0.01). There was one functional complication: one DIP joint fusion secondary to one of the recurrences. The average QuickDASH was 2.3/100 (range 0–31).
Giant cell tumors of the synovial sheaths in the hand are benign lesions where recurrence is the primary risk. The recurrence typically occurred within 36 months of the excision. Intra-articular tumor development, marginal resection and tendon involvement seem to contribute to recurrence. There was no correlation found between the histological type of tumor (encapsulated or not) and recurrence.
IV.
Anatomical snuffbox lipoma causing nervous compression. A case report
2012, Annales de Chirurgie Plastique Esthetique
Les lipomes sont très rarement localisés au niveau de la main. La localisation au niveau de la tabatière anatomique reste exceptionnelle. Les auteurs rapportent le cas d’un patient ayant présenté un lipome compressif de la branche latérale de la branche sensitive du nerf radial au niveau de la tabatière anatomique.
Lipomas are rarely localized at the hand, and more unfrequently at the anatomical snuffbox. We report a case of a lipoma that compressed the lateral branch of the superficial sensory branch of the radial nerve.
Radiologic Examination of the Hand
2010, Plastic Surgery Secrets Plus

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Pictorial review: Magnetic resonance imaging of benign soft tissue masses of the hand and wrist

Radiologic Clinics of North America

Clinical Radiology

Magnetic Resonance Imaging

Clinical Imaging

Tumour and tumour-like conditions of the soft tissue: magnetic resonance imaging features differentiating benign from malignant masses

The British Journal of Radiology

Diagnosis of soft-tissue masses with MR imaging: can benign masses be differentiated from malignant ones?

Radiology

MR imaging of soft-tissue masses (letter)

American Journal of Roentgenology

Value of MR imaging in differentiating benign from malignant softtissue masses: study of 95 lesions

American Journal of Roentgenology

Soft tissue masses: diagnosis using MR imaging

American Journal of Roentgenology

Benign soft tissue masses of the wrist and hand: MRI appearances

Skeletal Radiology