2015
DOI: 10.5811/westjem.2015.4.25888
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Point-of-care Ultrasound to Identify Distal Ulnar Artery Thrombosis: Case of Hypothenar Hammer Syndrome

Abstract: Hypothenar hammer syndrome (HHS) is a rare condition of distal ulnar artery injury and thrombosis secondary to repetitive blunt trauma to the hypothenar area. We present a case of HHS for which point-of-care ultrasound (POCUS) was used as the initial means of imaging, prompting management and disposition without further imaging studies ordered in the emergency department (ED). This case demonstrates the utility of POCUS to aid the Emergency Physician in the diagnosis and management of patients with extremity v… Show more

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Cited by 4 publications
(9 citation statements)
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References 14 publications
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“…Conditions such as hypothenar hammer syndrome can be diagnosed at the point of care without the need for more expensive or invasive modes of angiography. 5 But more importantly, the UHFUS technology also provides information about the quality of the vessel wall itself by measurements of intimal thickness. Ultrahigh frequency probes clearly delineate the individual layers of the vessel walls, with the intimal layer appearing as a bright hyperechoic layer between the vessel lumen and the hypoechoic medial layer (Figures 7a and 7b).…”
Section: Resultsmentioning
confidence: 99%
“…Conditions such as hypothenar hammer syndrome can be diagnosed at the point of care without the need for more expensive or invasive modes of angiography. 5 But more importantly, the UHFUS technology also provides information about the quality of the vessel wall itself by measurements of intimal thickness. Ultrahigh frequency probes clearly delineate the individual layers of the vessel walls, with the intimal layer appearing as a bright hyperechoic layer between the vessel lumen and the hypoechoic medial layer (Figures 7a and 7b).…”
Section: Resultsmentioning
confidence: 99%
“…Additionally, point of care ultrasound has been used to aid in diagnosis of this syndrome. 4 Management ranges from conservative medical management to endovascular thrombolysis or surgical grafting, as in this case. 2 …”
Section: Discussionmentioning
confidence: 99%
“…Los pacientes suelen acudir con dolor hipotenar y los dedos afectados (3.º, 4.º y 5.º) fríos y pálidos, cambios de coloración, lesiones tróficas por isquemia digital (hallazgos en las yemas de los dedos, como hemorragias en astilla, ulceraciones y gangrena), parestesias en el territorio del nervio cubital y, en ocasiones, una masa palpable en la eminencia hipotenar por la formación de un aneurisma sobre este sitio y posteriormente un trombo. 1,3,6,11 La ausencia del cambio de color trifásico que se observa en el fenómeno de Raynaud clásico, que no afecta el pulgar, es un indicio diagnóstico. 11 La hipersensibilidad hipotenar y una prueba de Allen anormal (lentitud o ausencia completa de llenado de la mano con la arteria radial ocluida) ayudan a confirmar el diagnóstico.…”
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“…1,3,6,11 La ausencia del cambio de color trifásico que se observa en el fenómeno de Raynaud clásico, que no afecta el pulgar, es un indicio diagnóstico. 11 La hipersensibilidad hipotenar y una prueba de Allen anormal (lentitud o ausencia completa de llenado de la mano con la arteria radial ocluida) ayudan a confirmar el diagnóstico. 2,3 Por supuesto, se deben tener en cuenta aquellos trastornos que pueden provocar muchos de estos mismos síntomas, como artritis reumatoide, enfermedad de Buerger, síndrome de salida torácica, fenómeno de Raynaud, lupus eritematoso y esclerodermia.…”
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