Soft tissue ultrasound uses high-frequency transducers (typically 10–18 MHz) to produce detailed images of subcutaneous and superficial soft tissue structures. It is the first-line investigation for any palpable lump or swelling that cannot be diagnosed clinically, and is particularly valuable for distinguishing between cystic and solid lesions, identifying lipomas, assessing lymph nodes, and guiding aspiration or biopsy of superficial lesions.
Ultrasound is superior to MRI for superficial soft tissue assessment in most clinical scenarios because of its real-time capability, high spatial resolution for superficial structures, and ability to correlate the image with the palpable finding during the scan.
Soft tissue ultrasound can identify and characterise lipomas, sebaceous cysts (epidermoid cysts), ganglion cysts, lymph nodes (reactive, infective, or malignant), haematomas, abscesses, foreign bodies, vascular lesions (haemangiomas, arteriovenous malformations), and superficial soft tissue tumours. It is also used to assess post-surgical seromas and haematomas, and to guide aspiration or biopsy of superficial lesions.
Lipomas are the most common benign soft tissue tumour. They are composed of mature fat cells and appear on ultrasound as well-defined, compressible, hyperechoic or isoechoic lesions with a thin capsule. They are almost always benign and require no treatment unless symptomatic or cosmetically troublesome. Sebaceous cysts (epidermoid cysts) appear as well-defined, oval, hypoechoic lesions with a thin wall and posterior acoustic enhancement. They are benign and typically managed conservatively unless infected or enlarging.
Lymph node ultrasound assesses the size, shape, echogenicity, and vascularity of lymph nodes. Normal lymph nodes are oval, have a preserved fatty hilum, and show hilar vascularity on Doppler. Abnormal features include rounded shape, loss of fatty hilum, cortical thickening, and peripheral or mixed vascularity. These features may indicate reactive lymphadenopathy (infection or inflammation), lymphoma, or metastatic disease, and typically require clinical correlation and possible biopsy.
Lumps and bumps are one of the most common reasons patients self-refer for a private scan. The lump has often been present for months or years; the patient has been told by their GP that it is probably a lipoma or cyst, but they want confirmation. In the majority of cases, the scan confirms the benign diagnosis and provides the reassurance the patient was seeking. In a small proportion of cases, the scan identifies features that require further investigation, and the patient is advised to return to their GP with the report. In both scenarios, the scan has provided clinically useful information and resolved the uncertainty that was causing anxiety.
Drawn from typical cases seen at our Marylebone clinic. This is a composite scenario representative of patterns we encounter regularly.
Our lumps and bumps ultrasound scan is available from £235 at our Marylebone clinic. The scan assesses any palpable lump or swelling anywhere on the body surface. No GP referral is required. Findings are explained verbally at the end of the scan and a written report is sent within 24 hours.
Ultrasound can identify features that are suspicious for malignancy, but it cannot provide a definitive diagnosis of cancer — that requires tissue sampling (biopsy). If the scan identifies suspicious features, the report will recommend biopsy and GP follow-up. The majority of superficial lumps are benign.
Most lumps and bumps scans take 20 to 30 minutes. If multiple lumps are being assessed, the appointment may be slightly longer.
Available Monday to Saturday at our Marylebone clinic. No GP referral needed. Instant verbal results. Written report within 24 hours.
