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Imaging Features of Pseudoaneurysms of the Hand in Children and Adults

¹ Department of Radiology, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland.
² Department of Plastic and Reconstructive Surgery, Kantonspital Aarau, 5000 Aarau, Switzerland.
³ Department of Orthopedics, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland.
⁴ Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.
⁵ Department of Pathology, University Institute of Bern, Inselspital, CH-3010 Bern, Switzerland.
⁶ IMAMED Radiologie Nordwest, 4058 Basel, Switzerland.
⁷ Department of Radiology, The James Cook University Hospital, Middlesborough, TS4 4BW United Kingdom.
⁸ Department of Radiology, University of California San Francisco, San Francisco, CA 94143.

OBJECTIVE. Our objective was to review the imaging features of pseudoaneurysms of the hand in 25 patients. The patients presented with a mass, peripheral paresthesia, or ischemia. Pseudoaneurysm of the hand is a rare and often clinically unsuspected diagnosis. Correct diagnosis is important because there are risks for distal embolic disease with ischemia or gangrene of the fingers, ulnar or digital nerve dysfunction, rupture, or bone erosion and joint destruction. Scant reports appear in the world literature, and this report is the first review, to our knowledge, of the imaging features. The cause may be a history of a single direct trauma or chronic trauma, as seen in patients with hypothenar or thenar hammer syndrome.

CONCLUSION. Awareness of the specific imaging appearances of pseudoaneurysms of the hand and their complications may improve the accuracy of radiologic diagnosis, advance the preoperative workup, and prevent possible clinical complications such as digital gangrene, nerve dysfunction, and aneurysm rupture.

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