The patient is a 63-year-old woman who has a three-month history of severe pain and discoloration at the nail bed of her right thumb. Routine radiographs were normal. An ultrasound examination with color and power Doppler was performed.
The patient is a 63-year-old woman who has a three-month history of severe pain and discoloration at the nail bed of her right thumb. Routine radiographs were normal. An ultrasound examination with color and power Doppler was performed.
FIGURE A. Longitudinal ultrasound image at the dorsal aspect of the distal phalanx of the right thumb demonstrates an isoechoic mass (arrowheads) that is difficult to separate from the surrounding soft tissues. There is slight erosion of the underlying bone. The normal left side is included for comparison. FIGURE B. Longitudinal color Doppler ultrasound image of right thumb demonstrates abundant vascularity that is slightly splayed around the mass (arrowhead). FIGURE C. Longitudinal power Doppler ultrasound image at the same level, again showing abundant vascularity.
Glomus tumor of the finger.
None. Appearance and location are pathognomonic.
The glomus tumor is a benign neoplasm that is typically located in the subungual region of the distal phalanx of the finger.1 This lesion is more common in women and typically presents with a small red-blue nodule under the fingernail that causes pain, exquisite tenderness, and temperature sensitivity.1 The nail may be ridged and discolored.1 Glomus tumors of the finger may be hard to detect on gray-scale sonography but typically appear hypoechoic, and erosion of the adjacent bone may be seen.1,2 Color Doppler analysis shows markedly increased blood flow and is helpful in confirming the diagnosis.2,3 Surgical excision is curative, but if the lesion is not removed completely, local recurrence is common.1 Sonography may be useful for preoperative assessment to ensure complete removal.2,3
REFERENCES
1. Fornage BD. Glomus tumors in the fingers: diagnosis with US. Radiology 1988;167(1):183-185.
2. Chen SH, Chen YL, Cheng MH, et al. The use of ultrasonography in preoperative localization of digital glomus tumors. Plast Reconstr Surg 2003;112(1):115-119.
3. Matsunaga A, Ochiai T, Abe I, et al. Subungual glomus tumour: evaluation of ultrasound imaging in preoperative assessment. Eur J Dermatol 2007;17(1):67-69.
Case submitted by Dr. Levon N. Nazarian, a professor of radiology at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania.
MRI-Based AI Radiomics Model Offers 'Robust' Prediction of Perineural Invasion in Prostate Cancer
July 26th 2024A model that combines MRI-based deep learning radiomics and clinical factors demonstrated an 84.8 percent ROC AUC and a 92.6 percent precision-recall AUC for predicting perineural invasion in prostate cancer cases.
Breast MRI Study Examines Common Factors with False Negatives and False Positives
July 24th 2024The absence of ipsilateral breast hypervascularity is three times more likely to be associated with false-negative findings on breast MRI and non-mass enhancement lesions have a 4.5-fold likelihood of being linked to false-positive results, according to new research.
Can Polyenergetic Reconstruction Help Resolve Streak Artifacts in Photon Counting CT?
July 22nd 2024New research looking at photon-counting computed tomography (PCCT) demonstrated significantly reduced variation and tracheal air density attenuation with polyenergetic reconstruction in contrast to monoenergetic reconstruction on chest CT.