Ulnar-sided hand ischemia after repetitive trauma, suspected hypothenar hammer syndrome
Recommended: CT / MR Angiography Hand or Doppler US is the preferred imaging study for ulnar-sided hand ischemia after repetitive trauma, suspected hypothenar hammer syndrome. Ulnar artery aneurysm / occlusion at hook of hamate from repetitive impact.
Recommended study
CT / MR Angiography Hand or Doppler US
Ulnar artery aneurysm / occlusion at hook of hamate from repetitive impact. Mechanics, construction workers, baseball catchers.
If the default doesn't apply
Definitive treatment planning
Catheter angiography + revascularization
IV contrast
Watch-outs
Digital embolization
Aneurysm thrombosis embolizes to digital arteries — fingertip ischemia.
Pearls
- Corkscrew appearance of ulnar artery in distal forearm / palm.
- Allen test usually abnormal.
- Treatment: excision + interposition graft for aneurysm; conservative for asymptomatic stenosis.