An assessment of Ultrasound screening for soft tissue lumps referred from primary care

To assess the efficacy of ultrasound as a screening tool in the assessment of soft-tissue masses referred from primary care and to investigate the incidence of malignancy in this population.

Retrospective analysis was performed on patients who underwent ultrasound for a suspected soft-tissue mass at our centre between January 2011 and December 2012. Patient demographics, ultrasound findings, further imaging investigations and histopathology were recorded. Patient records were followed up for a minimum period of 4 years.

A benign sonographic diagnosis was found in 95% (2271/2399) patients and 91% (2069/2399) required no further imaging or histopathology assessment. Ninety-six patients with a benign sonographic diagnosis had a benign histological diagnosis and one patient was found to have a histologically proven malignancy. Five percent (122/2,399) had an indeterminate scan. Of these, 40 had a histologically proven benign lesion and 10 had a histologically proven malignancy. Six of the 2,399 (0.2%) patients had scans suggestive of malignancy with histological confirmation. In total, 0.7% (17/2399) had proven malignant lesions. Eight were sarcomas.

The present study, which to the authors' knowledge is the first to focus on ultrasound assessment of musculoskeletal masses referred solely from primary care, confirms ultrasound as a highly effective screening tool. It often avoids the need for further investigation and inappropriate clinical referrals. Malignant lesions are very rare in this patient cohort.