ULTRASONIC IMAGE OF THE HYPOTHENAR HAMMER SYNDROME

A traumatic lesion of the ulnar artery (Hypothenar Hammer Syndrome, HH S) is a very rare cause of acral ischemia of the upper extremity. Aim: Evaluation of the efficacy of ultrasound techniques in the diagnosis of the HSS. Method: Based on the knowledge of the patient's history an d clinical examination we investigated forearm, hand and digital arter ies by continuous wave Doppler. By means of colour-coded duplex sonogr aphy (CCDS) we demonstrated the course of the radial and ulnar arterie s to the palmar arch. For comparison we used the results of preinterve ntion angiography. Results: The diameter of the distal ulnary artery m easured in healthy women was 1.8 +/- 0.32 and in men 2.2 +/- 0.46 mm. Among 268 patients with ischemia of the hands we diagnosed HHS in four cases. We identified an aneurysm of the ulnary artery in one case and a thrombotic occlusion in three cases. The thrombotic occlusion of th e ulnar artery led to a dilatation of the vascular lumen. The occlusio n length could be determined. Vessels diameter and echogenecity gave i nformation about the age of the thrombosis. Conclusion: The continuous wave Doppler is a major diagnostic contribution because of its abilit y to register hemodynamic changes. Additionally, CCDS with its combina tion of sonomorphology and hemodynamics enables a distinction between HHS and other causes of digital ischemia. The CCDS more precisely refi nes the indications for preinterventional angiography in acute ischemi a syndromes of the hand.