High-resolution ultrasound findings in the symptomatic residual limbs of amputees

Introduction: Amputations are increasingly prevalent because of medical complications associated with diabetes, meningitis, peripheral vascular disease, and neoplasms as well as road traffic accidents and war. The use of ultrasound (U/S) to diagnose the cause of pain in the residual limb of amputees is presented together with a review of the literature.

Patients and methods: 133 civilian patients with one or more amputations were included in the study. They were seen over a 2-year period, at the Douglas Bader Unit, Queen Mary's Hospital, Roehampton, Surrey, United Kingdom, in an outpatient setting. Patients were scanned using a Philips ATL/HDI 5000 U/S scanner.

Results: There were 89 male and 44 female patients, age range 14 to 91 years, with a total of 136 amputated sites. 80% of amputations involved the lower limb. Neuromas were the most frequently found lesions, followed by inflammatory edema, soft-tissue calcifications, bony spurs, soft-tissue infection, overuse injuries, bursae, and skin lesions. Scar tissue, bony erosion, bone infection, aneurysm formation, venous thrombosis, and myodesis failure were less frequently seen.

Conclusions: There is a wide spectrum of lesions in the amputated limb, which can be visualized by high-resolution U/S. Neuromas were the most frequent lesions seen.