NonInvasive Vascular Testing for Diagnosis and Management of Hypothenar Hammer Syndrome

Hypothenar hammer syndrome (HHS) is a rare condition that may present as a palmar mass due to an aneurysm, or more frequently as digit ischemia due to thromboembolic or occlusive disease of the distal ulnar artery. Often, patients presenting with HHS are young male smokers with an occupational history of repetitive trauma because of working with machinery or engaging in sports where there is regular impact against the palm. Conditions that may present with similar complaints are vasospastic conditions and inflammatory processes. Noninvasive vascular laboratory studies can be used prior to direct arteriogram to help establish the diagnosis of HHS and guide the therapeutic options for treatment.