High-frequency ultrasound is a powerful, accessible, and cost-effective imaging modality for the evaluation of focal finger lesions. By providing detailed anatomical and vascular information, HFUS enables confident differentiation among cystic, vascular, neural, and solid lesions, often allowing a specific or narrow differential diagnosis at the point of care.

Recognition of characteristic sonographic patterns—such as joint communication in synovial cysts, intense vascularity in glomus tumors, and nerve continuity in peripheral nerve sheath tumors—can significantly impact clinical decision-making, reduce unnecessary biopsies or surgeries, and guide appropriate referral and follow-up.

This pictorial review reinforces the role of high-frequency ultrasound as a first-line imaging technique in patients with finger masses and highlights its particular value in the assessment of peripheral nerve-related lesions, where it complements clinical evaluation and supports personalized patient management.