Comparing the Diagnostic Accuracy of Clinical and Radiological Measures in Hand Soft-Tissue Masses

Abstract

Introduction Imaging modalities are imperative to aid in diagnosing hand soft-tissue tumors. Limited insight is available into the diagnostic accuracy of history and physical examination in comparison to radiological diagnosis. Methods In this retrospective analysis, data of patients with hand soft-tissue tumors that were surgically treated and diagnosed through biopsy were extracted; taking this as a reference, the sensitivity, specificity and positive and negative predictive values and likelihood ratios of the clinical approach and radiological tools were contrasted against each other. Results Data of a total of 34 patients were revised in this study. With a mean age of 40.1 years, the most common anatomical area of the hand to be affected by the tumors was the index (n = 7, (18.9%); ganglion cysts were the most common tumor (n = 9, 26.5%) and magnetic resonance imaging was the most commonly used imaging modality (n = 24, 70.6%). Clinical diagnosis scored a sensitivity and specificity of 44.4% and 100% in ganglion cysts and 62.5% and 86.2% in giant cell tumors in contrast to the sensitivity and specificity of 66.7% and 100% for ganglion cysts and 50% and 90% for giant cell tumors scored by radiological modalities. Conclusion Clinical diagnosis could be non-inferior to radiological diagnosis, yet radiological examination remains a valuable adjunct to clinical examination. Larger scale, prospective studies are required before generalizing our results.

Keywords: clinical diagnosis; diagnostic accuracy; radiological diagnosis; soft tissue masses.