e-CASES: Hypothenar hammer syndrome
A 29-year-old male, right-handed,car-mechanic worker, complaining of pain and swelling in the hypothenar region
@1.1 ultrasound showing hypoechogenicareawith doppler ulnar artery flow restriction
MRI and angio MR showing complete occlusion of ulnar artery at level of hamate bone from thrombosed ulnar artery aneurysm; radial artery contributes to blood arterial supply
Hypothenar hammer syndrome
Thrombosed ulnar artery aneurysm of the dominant hand of a manuel worker
CHARACTERISTIC CLINICAL FEATURES AND RADIOLOGIC FINDINGS
Most aneurysms of the hand and wrist involve the ulnar artery which is hammered against the hook of the carpal hamate bone in the hypothenar eminence.
Ultrasound and MRI are actually the most accurate methods for diagnosing and locating ulnar artery aneurysms; arteriography is mandatory to document the professional disease.
Arteriography showing complete occlusion of ulnar artery
Other etiology of ischemia of the hand (thoracic outlet syndrome, arteriosclerosis or thromboangiitis obliterans)
- Anderson SE et al. Imaging features of pseudo anevrysms of the hand in children and adults. AJR:180, March 2003
- Blum AG et al. Pathologic conditions of the hypothenar eminence: Evaluation with multidetector CT and MR Imaging RadioGraphics 2006; 26: 1021-1044
- Liskutin J, Dorffner R, Resinger M, Silberbauer K, Mostbeck G. Hypothenar hammer syndrome.Eur Radiol. 2000