High-Resolution Ultrasound in the Diagnosis of Upper Limb Disorders: A Tertiary Referral Centre Experience.

Annals of Plastic Surgery. 61(3):259-264, September 2008.

Allen, Gina M. BM, DCH, MRCP, MRCGP, FRCP, MFSEM *; Drakonaki, Eleni E. MD +; Tan, Melissa Ley H. MBChB ++; Dhillon, Manpreet MBChB, MRCS, FRCR ++; Rajaratnam, Vaikunthan MBBS, AM, MBA(USA), FRCS, FICS(USA) ++[S]

Abstract:
The purpose of this study is to determine the reliability of high-resolution ultrasound (HRUS) in the diagnosis of upper limb disorders compared with the initial clinical opinion. We prospectively studied 178 patients referred for HRUS examination (47.2% hand, 34.8% wrist, and 18% elbow examinations) by recording the clinical opinion, the specific ultrasound diagnosis, and the final diagnosis, as established by surgery (79.9%) or follow-up (20.1%). HRUS examination was highly reliable in diagnosing cystic lesions, synovial disease, ligament injury and foreign bodies (100%), and slightly less reliable for solid lesions (82.1%) and nerve, bone, and tendon disorders (97%, 91.7%, 86.5%, respectively). HRUS examination resulted in significantly more correct diagnoses (92.1%) than the clinical opinion (70.8%) (McNemar test, P = 0.001). The agreement between the HRUS diagnosis and the clinical opinion was slight (Kappa test, k = 0.16). HRUS examination is more reliable than clinical examination in diagnosing upper limb disorders.