Hook of hamate fracture (ultrasound)

Case contributed by Maulik S Patel
Diagnosis certain


History of fall on ground resulting in right hand trauma about 3 weeks back. Complaining of pain in hypothenar region.

Patient Data

Age: 30 years
Gender: Male

There is cortical breach at base of hamate hook. Ulnar artery overlying hook of hamate is patent. Asymptomatic side shows normal continuity of hamate hook.

There is a lobulated, thin walled, anchoic lesion abutting palmer aspect of distal radius - ulna, deep to pronator quadratus muscle. Neck of the lesion extends to distal radio-ulnar joint.

There is a fracture of the hook of the hamate.

Case Discussion

This young male had a fall on ground resulting in trauma to the palmar aspect of right hand about 3 weeks back. He had persistent pain in the hypothenar region. Hand radiograph was said to be normal. However, radiograph was not available to review at the time of ultrasound.

Ultrasound shows cortical breach in hook of hamate. There is an additional finding of a ganglion from the palmer aspect of distal radioulnar joint.

CT scan was done later which showed fracture of hook of hamate. CT scan courtesy of Dr Chinmay Shah.

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