Abstract
Sonography is a quick, noninvasive way to evaluate superficial masses. Although the information provided can answer important questions about the nature of these masses, the sonographer must have as much clinical information as possible and make sure that each piece of the puzzle fits and makes sense in relation to the known facts. The value of the information contained in the images will not be maximized if sonographers do not have complete clinical information and the ability to integrate the various components to arrive at an appropriate diagnosis. This case illustrates the need to consider all the possibilities, even when, at first glance, the diagnosis seems obvious. (When you hear hoof beats, it is probably a horse...but it may be a zebra!)