title: Radial Artery Pseudoaneurysm with Aberrant Radial Artery Anatomy: An Unusual Presentation of Flexor Tenosynovitis.
abstract: PurposeRadial 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.MethodsWe 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.ResultsExamination of the three-dimensional CT angiogram showed an unusual anatomical variant that likely predisposed him to isolated long finger flexor tenosynovitis.ConclusionPrompt 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.
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Calotta
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Gornet
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
authors.forename: Edward F
authors.initials: EF
authors.lastname: McCarthy
authors.affiliation: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
authors.forename: Donna
authors.initials: D
authors.lastname: Magid
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
authors.forename: E Gene
authors.initials: EG
authors.lastname: Deune
keywords: anatomical variant; injection drug abuse; radial artery pseudoaneurysm; suppurative flexor tenosynovitis