This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Barker, C. Articles by Ball, D. R. Search for Related Content PubMed PubMed Citation Articles by Barker, C. Articles by Ball, D. R.

---

LETTER TO THE EDITOR

Portable Ultrasound to Diagnose True Radial Artery Aneurysm

Specialist Registrar in Anaesthesia; Department of Anaesthesia; Dumfries and Galloway Royal Infirmary; Dumfries, UK (Barker) Consultant in Anaesthesia; Department of Anaesthesia; Dumfries and Galloway Royal Infirmary; Dumfries, UK; dball{at}nhs.net (Jefferson, Ball)

To the Editor:

In a recent letter, Baumgarten (1) described the increasing application of ultrasound by anesthesiologists. True radial artery aneurysm is rare and we report one readily diagnosed by ultrasound at "point of care." An elderly man presented for revision vascular surgery. A pulsatile but nonexpansile swelling was seen at his wrist (Fig. 1) Allen's test was 15 s, suggesting the majority of the hand's blood supply was supplied by the aneurysmal radial artery. The swelling had been present for years and there was no history of previous trauma or cannulation. Portable ultrasound (I Look^TM, SonoSite, Bothell, WA) confirmed the aneurysm (Fig. 2).

View larger version (47K): [in this window] [in a new window]   Figure 1. Hand showing swelling at the wrist.

View larger version (63K): [in this window] [in a new window]   Figure 2. Ultrasound image of the wrist swelling.

Swellings such as these can be misdiagnosed and present for excision. Of note are volar ganglia at the wrist (2). Indeed the radial artery may form part of a ganglion wall (3). Sonography is used to distinguish solid or cystic extravascular lesions around the wrist and distinguish them from the radial artery (4). Indeed, Doppler ultrasound is recommended as a standard investigation for volar wrist swelling (5). In our case, ultrasound allowed a rapid and accurate diagnosis.

REFERENCES

1. Baumgarten R. The real ultrasound revolution. Anesth Analg 2007;104:1292[Free Full Text]
2. Yaghoubian A, de Virgilio C. Noniatrogenic aneurysm of the distal radial artery: a case report. Ann Vasc Surg 2006;20: 784–6[Web of Science][Medline]
3. Kerr CD, Duffey TP. Traumatic false aneurysm of the radial artery. J Trauma 1988;28:1603–4[Web of Science][Medline]
4. Turner WH, Turnball AR. True radial artery aneurysm. Br J Surg 1988;75:233[Web of Science][Medline]
5. Gooding GAW. Sonography of the radial artery at the wrist. Am J Roentgenol 1988;150:629–31[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Barker, C. Articles by Ball, D. R. Search for Related Content PubMed PubMed Citation Articles by Barker, C. Articles by Ball, D. R.