The role of the plain radiograph in the characterisation of soft tissue tumours.

A radiograph is often the first investigation to be requested when a patient presents with limb pain or a mass. Whilst we do not advocate that this is the only investigation to be employed in the evaluation of such patients, a working knowledge of the variety of abnormal findings that can present in the soft tissues on radiographs remains useful. We reviewed the radiographic findings of soft tissue masses from a prospectively compiled database of all such lesions presenting to a specialist orthopaedic oncology service over the past 8 years. Of the cohort of 1,058 individuals with a proven soft tissue tumour, 454 had had a radiograph taken of the affected area. Of these, 281 (62%) patients had a positive radiographic finding. The most common findings were a visible soft tissue mass (n = 141), the presence of calcification (n = 76), fat (n = 32) and evidence of bone involvement (n = 62). More than one finding was sometimes present in the same patient. These findings were present in both benign and malignant tumours. This review article describes the incidence and diagnostic relevance of these plain film findings for suspected soft tissue tumours.