Pictorial Review of Magnetic Resonance Imaging Features in Hand and Finger Masses: Experience from a Musculoskeletal Reference Center

Purpose or Learning Objective: To analyze retrospectively the magnetic resonance imaging (MRI) features of a consecutive series of palpable masses in the hand and fingers.

Methods or Background: We performed a retrospective review of MRI examinations and case records of patients referred to our institution for a palpable mass in the hand from January 2011 to January 2013. When ultrasonography (US) was not conclusive in the diagnosis, MRI was performed (1.5 T or 3 T). If the MRI was not deemed sufficient for diagnosis, a biopsy for histologic characterization of the mass was performed.

Results or Findings: A total of 77 patients (45 women and 32 men; mean age: 46.4 years) were included in our study. MRI demonstrated a cause for a palpable mass in 75 cases (97%). Soft tissue tumors were detected in 58 of 77 patients; bone tumors were found in 19 of 77 cases. Nontumoral pathology was found in 22 cases: ganglion cysts, gouty tophi, and rheumatoid nodules. A majority of lesions were benign (46/77), mostly giant cell tumors and enchondromas. Only nine represented malignant pathology (two chondrosarcomas, two epithelioid sarcomas, two rhabdomyosarcomas, one Ewing’s sarcoma, one extra-axial chordoma, and one spinocellular carcinoma). No evidence of a focal lesion was found in two cases. Final diagnosis was obtained by the combination of clinical and radiologic features (70 cases) or by biopsy (7 cases).

Conclusion: Most soft tissue masses in the hand are benign and can be characterized with US. When US examination is inconclusive, MRI can discriminate further and rule out malignancy. In several cases, biopsy cannot be avoided.

Publication History

Article published online:
22 May 2024