Factors Associated with Requesting Magnetic Resonance Imaging during the Management of Glomus Tumors

Document Type : RESEARCH PAPER

Authors

1 Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, Massachusetts, United States of America

2 Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, Massachusetts, United States of America Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America

3 Massachusetts General Hospital, Boston, Massachusetts, United States of America Dell Medical School, The University of Texas, Austin, United States of America

Abstract

Background: The characteristic clinical presentation of glomus tumors and the low negative predictive value of the
magnetic resonance imaging (MRI) raise the question whether MRI improves their management. Therefore, this study
aimed to investigate whether MRI improved the management of glomus tumors.
Methods: In total, 87 patients with a histologically confirmed glomus tumor were treated over a 25-year period and
analyzed retrospectively. Multivariable logistic regression analysis was used to evaluate the independent predictors of
an MRI request during the management of glomus tumors.
Results: According to the results, the patients who were treated by orthopaedic surgeons were more likely to have an
MRI during the management of a glomus tumor.
Conclusion: The role of an MRI during the management of a glomus tumor is unclear. Orthopaedic surgeons are
more likely to request an MRI. Furthermore, visible lesions with characteristic symptoms probably do not benefit
from MRI. However, it may help to be sure that the highest-quality MRI is used with the best possible coil for the
finger.
Level of evidence: IV

Keywords

Main Subjects


1. Beksac K, Dogan L, Bozdogan N, Dilek G, Akgul GG,
Ozaslan C. Extradigital glomus tumor of thigh. Case
Rep Surg. 2015; 2015(1):638283.
2. Polo C, Borda D, Poggio D, Asuncion J, Peidro L.
Glomus tumor of the hallux. Review of the literature
and report of two cases. Foot Ankle Surg. 2012;
18(2):89-93.
3. González-Orús Á􀆵 lvarez-Morujo RJ, Arí􀆴stegui Ruiz MÁ􀆵 ,
da Costa Belisario J, Martinez Guirado T, Scola Yurrita
B. Head and neck paragangliomas: experience in 126
patients with 162 tumours. Acta Otorrinolaringol
Esp. 2015; 66(06):332-41.
4. Gombos Z, Zhang PJ. Glomus tumor. Arch Pathol Lab
Med. 2008; 132(9):1448-52.
5. Mravic M, LaChaud G, Nguyen A, Scott MA, Dry SM,
James AW. Clinical and histopathological diagnosis
of glomus tumor: an institutional experience of 138
cases. Int J Surg Pathol. 2015; 23(3):181-8.
6. Fazwi R, Chandran PA, Ahmad TS. Glomus tumour:
a retrospective review of 15 years experience in a
single institution. Malays Orthop J. 2011; 5(3):8-12.
7. Frikh R, Alioua Z, Harket A, Ghfir M, Sedrati O.
Glomus tumors: anatomoclinical study of 14 cases
with literature review. Ann Chir Plast Esthet. 2009;
54(1):51-6.
8. Venugopal PR. Extradigital glomus tumor-a rare
cause for undiagnosed chronic pain in unusal sites.
Indian J Surg. 2015; 77(Suppl 3):910-2.
9. Boudghene FP, Gouny P, Tassart M, Callard P,
Breton CL, Vayssairat M. Subungual glomus tumor:
combined use of MRI and three-dimensional
contrast MR angiography. J Magn Reson Imaging.
1998; 8(6):1326-8.
10. Glazebrook KN, Laundre BJ, Schiefer TK, Inwards CY.
Imaging features of glomus tumors. Skeletal Radiol.
2011; 40(7):855-62.
11. Ham KW, Yun IS, Tark KC. Glomus tumors: symptom
variations and magnetic resonance imaging for
diagnosis. Arch Plast Surg. 2013; 40(4):392-6.
12. McDermott EM, Weiss AP. Glomus tumors. J Hand
Surg Am. 2006; 31(8):1397-400.
13. Tang CY, Tipoe T, Fung B. Where is the lesion?
glomus tumours of the hand. Arch Plast Surg. 2013;
40(5):492-5.
14. Van Geertruyden J, Lorea P, Goldschmidt D, de
Fontaine S, Schuind F, Kinnen L, et al. Glomustumours
of the hand. A retrospective study of 51 cases. J Hand
Surg Br. 1996; 21(2):257-60.
15. Chou T, Pan SC, Shieh SJ, Lee JW, Chiu HY, Ho
CL. Glomus tumor: twenty-year experience and
literature review. Ann Plast Surg. 2016; 76(Suppl
1):S35-40.
16. Ekin A, Ö􀇆 zkan M, Kabaklioglu T. Subungual glomus
tumours: a different approach to diagnosis and
treatment. J Hand Surg Br. 1997; 22(2):228-9.
17. Trehan SK, Athanasian EA, DiCarlo EF, Mintz DN,
Daluiski A. Characteristics of glomus tumors in the
hand not diagnosed on magnetic resonance imaging.
J Hand Surg Am. 2015; 40(3):542-5.
18. Sandoval M, Carrasco-Zuber J, Gonzalez S. Extradigital
symplastic glomus tumor of the hand: report of 2
cases and literature review. Am J Dermatopathol.
2015; 37(7):560-2.
19. Khaled W, Drape JL. MRI of wrist and hand masses.
Diagn Interv Imaging. 2015; 96(12):1238-46.
20. Lee W, Kwon SB, Cho SH, Eo SR, Kwon C. Glomus tumor
of the hand. Arch Plast Surg. 2015; 42(3):295-301.
21. Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Subhi 
F, El-Shayeb AF. Magnetic resonance imaging in the
diagnosis of glomus tumours of the hand. J Hand
Surg Eur Vol. 2005; 30(5):535-40.
22. Beytemur O, Adanir O, Tetikkurt US, Gulec MA.
Glomus tumor located in deltoid muscle. Acta Orthop
Traumatol Turc. 2016; 50(2):242-4.
23. Cammisa C, Partridge G, Ardans C, Buehrer K,
Chapman B, Beckman H. Engaging physicians in
change: results of a safety net quality improvement
program to reduce overuse. Am J Med Qual. 2011;
26(1):26-33.
24. Emanuel EJ, Fuchs VR. The perfect storm of
overutilization. JAMA. 2008; 299(23):2789-91.
25. Solomon DH, Katz JN, Carrino JA, Schaffer JL, Bohn RL,
Mogun H, et al. Trends in knee magnetic resonance
imaging. Med Care. 2003; 41(5):687-92.
26. Matloub HS, Muoneke VN, Prevel CD, Sanger JR,
Yousif NJ. Glomus tumor imaging: use of MRI for
localization of occult lesions. J Hand Surg Am. 1992;
17(3):472-5.
27. Schiefer TK, Parker WL, Anakwenze OA, Amadio
PC, Inwards CY, Spinner RJ. Extradigital glomus
tumors: a 20-year experience. Mayo Clin Proc. 2006;
81(10):1337-44.