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J Hand Microsurg 2016; 08(03): 170-174
DOI: 10.1055/s-0036-1597552
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Radial Artery Pseudoaneurysm with Aberrant Radial Artery Anatomy: An Unusual Presentation of Flexor Tenosynovitis

Nicholas A. Calotta
1   Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Megan E. Gornet
1   Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Edward F. McCarthy
2   Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Donna Magid
3   Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
E. Gene Deune
1   Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
› Author Affiliations
Further Information

Publication History

09 October 2016

14 November 2016

Publication Date:
02 December 2016 (online)

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Abstract

Purpose Radial artery pseudoaneurysm is uncommon and mainly associated with radial artery cannulization for cardiac intervention or invasive hemodynamic monitoring. It is rarely seen as a result of intra-arterial recreational drug injection.

Methods We present the case of a 35-year-old man with a 12-year history of intravenous drug use and 1-year history of intra-arterial drug use who developed radial artery pseudoaneurysm with a right long finger suppurative flexor tenosynovitis and subsequent acute radial-sided hand ischemia. Computed tomography (CT) angiography with three-dimensional reconstructions was used in diagnosis. We treated him with parenteral antibiotics followed by surgical debridement of his infection and removal of the infected pseudoaneurysm.

Results Examination of the three-dimensional CT angiogram showed an unusual anatomical variant that likely predisposed him to isolated long finger flexor tenosynovitis.

Conclusion Prompt diagnosis and treatment of pseudoaneurysm in this context is crucial to avoiding sepsis, hemorrhage, and irreversible ischemia. In rare cases, imaging can demonstrate an underlying anatomical variant that may be a predisposing factor.

Keywords

anatomical variant - injection drug abuse - radial artery pseudoaneurysm - suppurative flexor tenosynovitis
 

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