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
@8.20 Axial T1, @7.20 Axial T2 FS, @3.23 TWIST early image, @3.34 TWIST late image
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
DEFINITION
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.
@12.1 early film ; @13.1 later film.
Arteriography showing complete occlusion of ulnar artery
Other etiology of ischemia of the hand (thoracic outlet syndrome, arteriosclerosis or thromboangiitis obliterans)
fig-01
TWIST COR RES TEMP=2.6s_SUB_MIP_SAG
TWIST COR RES TEMP=2.6s_SUB_MIP_COR
TWIST COR RES TEMP=2.6s_SUB_MIP_TRA
TWIST COR RES TEMP=2.6s_TT=78.6s
TWIST COR RES TEMP=2.6s_TT=83.7s
DP TSE TRA FS
T1 TSE TRA
T1 TSE TRA FAT SAT
T1 TSE TRA FAT SAT GADO
T1 TSE SAG FAT SAT GADO
Fig-03a
Fig-03b
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