Sarcoma or haematoma? If only it was that simple! Part 1.

Introduction: Imaging appearances and clinical presentation of soft tissue sarcoma and soft tissue haematomas are similar. It is imperative that sarcoma is differentiated from benign soft tissue lesions due to the poor outcomes and high morbidity associated with sarcoma.

Topic description: Part 1 of this pictorial review will summarise the paucity of guidance in management of suspected haematomas, the clinical features and ultrasound techniques used in the assessment of soft tissue masses.

Discussion: Ultrasound is the first-line test in the investigation of soft tissue masses. With the overlapping ultrasound appearances of soft tissue sarcoma and soft tissue haematoma, thorough and methodical clinical examination and scanning technique is fundamental so that practitioners understand when to escalate cases for further investigation.

Conclusion: The clinical assessment and clinical history taking into consideration the intensity of trauma and ecchymosis must correlate with the ultrasound appearances. This will facilitate an accurate diagnosis, timely management and improved patient outcomes.