Presentation
Right hypothenar region bulge.
Patient Data
A well-defined, lobulated soft tissue lesion distal to the Guyon's canal. The lesion lies deep to the abductor digiti minimi and the accessory abductor digiti minimi muscles. It is heterogeneously hyperechoic with incomplete striations without cystic changes/ calcification/ vascularity. The ulnar nerve and artery are displaced to the radial side/ to a deeper plane by the lesion.
Cine-loop is aligned to the short-axis of the hypothenar region and runs from the proximal to the distal direction.
Fat density centered over the 5th metacarpal base. No fracture/ dislocation/ bone lesion.
Case Discussion
The patient presented with a hypothenar region bulge for the last two years causing mild discomfort. Ultrasound and radiograph show soft tissue lipoma. It is distal to the Guyon's canal in the intermuscular plane/ intramuscular plane. An accessory abductor digiti minimi is present which is a common extra-muscle. Clinically, there was no ulnar neuropathy due to the lipoma or accessory muscle.
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