Magnetic Resonance Imaging in the Diagnosis of Glomus Tumours of the Hand

Abstract

This paper studies the sensitivity, specificity and predictive values of MRI in the diagnosis of glomus tumours of the hand and investigates the final diagnosis and outcome in cases with false positive or negative imaging tests. A total of 42 cases with the clinical diagnosis of a glomus tumour were included in the study. All patients underwent MRI and the results of MRI were correlated with the final histological diagnosis of the excised lesion. MRI had a sensitivity of 90%, a specificity of 50%, a positive predictive value of 97% and a negative predictive value of 20%. The four cases in which the MRI was negative all proved histologically to be glomus tumours. All four tumours were small (2-3mm in diameter) and the lack of delineation of the lesions by MRI was attributed to their small size. Despite negative MRIs, surgical exploration identified the glomus tumours. Based on the results of the current study and the cost of MRI, the senior author has stopped ordering pre-operative MRIs in patients clinically diagnosed with a glomus tumour.

Glomus tumours of the hand: Review of literature

“…However, not all glomus tumours will show this nidus appearance. 5 Some glomus tumours have low signal intensity or isointensity on T2-weighted images and these lesions are better delineated with T2 fat suppression images, with the use of contrast MRI or with magnetic resonance angiography. 25 However, the classic MRI findings of a dark lesion on T1 and a bright lesion on T2-weighted images are not specific for glomus tumours.…”

“…Although this tumour can be found anywhere on the body, most common site of its occurrence is distal phalanx of the fingers, especially in the subungual region. 5 Though this is true in case of female population, males often have these tumours in other parts of the body. 6 In general, there are two types of glomus tumours, namely, solitary and multiple.…”

Glomus Tumour: Case Report

“…7 GT en sık 30-50 yaşları arasında görülmekte-dir. [8][9][10][11][12] Kadın predominansı görülmektedir. 2,7,12 Kadın-erkek oranı 2:1 olarak bildirilmiştir.…”

Extradigital Glomus Tumor—a Rare Cause for Undiagnosed Chronic Pain in Unusal Sites

“…Ultrasonography, despite its low specificity, may aid in locating the lesion. MRI provides more details of the lesion and its association with the adjacent structures [4]. It must be emphasized that a diagnosis relies on a high index of clinical suspicion.…”