Hand-arm vibration syndrome: A rarely seen diagnosis

Abstract

Hand-arm vibration syndrome (HAVS) is a collection of sensory, vascular, and musculoskeletal symptoms caused by repetitive trauma from vibration. This case report demonstrates how to diagnose HAVS on the basis of history, physical examination, and vascular imaging and its treatment options. A 41-year-old man who regularly used vibrating tools presented with nonhealing wounds on his right thumb and third digit. Arteriography revealed occlusions of multiple arteries in his hand with formation of collaterals. We diagnosed HAVS, and his wounds healed after several weeks with appropriate treatment. HAVS is a debilitating condition with often irreversible vascular damage, requiring early diagnosis and treatment.

Fig 1

Right upper extremity arteriogram demonstrating (a) patent radial, ulnar, and interosseous arteries at the distal forearm, (b) occlusion of the radial artery before the wrist, and (c) occlusion of the ulnar artery proximal to the wrist with collaterals providing blood supply to the lateral aspect of the hand.

Fig 2

Right upper extremity arteriogram demonstrating patency of two small areas of the superficial (*) and palmar (!) arches with absence of blood supply to the thumb and diminished blood supply to the second to fifth digits.