Differential Diagnoses of Pediatric Upper Limb Masses

Area of Science:

• Pediatric Orthopedics
• Skeletal Oncology
• Epidemiology

Background:

• Upper limb masses are common in outpatient settings, yet pediatric-specific epidemiological data is limited.
• Understanding the characteristics of these masses in children is crucial for accurate diagnosis and management.

Purpose of the Study:

• To determine the differential diagnoses of upper limb masses in pediatric patients (aged ≤18 years).
• To describe the clinical characteristics of pediatric upper limb masses.
• To establish an evidence-based clinical algorithm for managing these conditions.

Main Methods:

• Retrospective review of patients aged ≤18 years with upper limb masses over a 5-year period.
• Data collection included demographics, clinical features, imaging, intraoperative findings, and histology.
• Correlation between clinical and histopathological diagnoses was assessed for surgical cases.

Main Results:

• 141 upper limb masses were analyzed; the mean age was 12 years.
• The majority (91%) of masses were benign, with 10% being malignant or locally aggressive.
• Common presentations included swelling, pain, and paresthesia; 31% of patients underwent surgery.

Conclusions:

• Pediatric upper limb masses are predominantly benign, but a significant minority present as malignant or locally aggressive disease.
• A clinical algorithm was developed to assist healthcare providers in the evaluation and management of pediatric upper extremity masses.