The value of sonography in diagnosing giant cell tumors of the tendon sheath.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic value of sonography in giant cell tumors of the tendon sheath.

METHODS: Sonographic findings and other clinical records were retrospectively reviewed and analyzed in 30 patients (45 lesions) with pathologically proven giant cell tumors of the tendon sheath. The sonographic findings were compared with those found at surgery.

RESULTS: The locations of the tumors included the hand (53.33%), wrist (10%), elbow (3.33%), knee (10%), and foot (23.33%). The sizes of the tumors ranged from 0.4 to 8 cm, with a mean size of 2.6 cm. All the lesions were shown as hypoechoic nodules with homogeneous or heterogeneous echogenicity. Thirty-two lesions (71.11%) had substantial flow, and 13 lesions (28.89%) had minimal flow. Thirty-four lesions were in contact with the tendon sheath; 5 were in contact with the joint; and 6 were in contact with both the tendon sheath and the joint. Bone erosions were found in 4 cases, and bone impressions were found in another 3 cases.

CONCLUSIONS: Sonography can provide exact information about a tumor and its relationship with the surrounding tissue, which indicates that it can be used as the first method to diagnose a giant cell tumor of the tendon sheath.