Page 104 - Journal of Special Operations Medicine - Fall 2016

An Ongoing Series

Left Hand Injury With Focal Swelling and Tenderness

Mariusz K. Urbaniak; Katarzyna (Kasia) Hampton, MD

28-year-old NATO Special Operations Forces (SOF) Figure 1 Clinical image and ultrasound image.
A Operator participates in a low-profile mission. Un-
fortunately, during combative training, he sustains a
left hand injury. He is reporting dorsal hand pain and
limited motion in his fifth finger. He denies any associ-
ated injuries. During assessment by his team medic, the
patient is noted to have focal swelling and tenderness
along the ulnar aspect of the left hand dorsum (Figure
1, clinical image). There is no scissoring of the fingers
in flexion, and the nails are coplanar when the fingers
are in extension. Neurovascular examination of the
left hand is normal. There are no associated puncture
wounds or lacerations. No other injuries are noted.

Given the mission profile, the decision is made not to use
a local hospital for radiographic imaging but to proceed
with sonographic assessment of the injury site instead.
Do you notice any concerning findings in Figure 1 (ultra-
sound image)? When treating similar injuries, would you
expect ultrasound to be a feasible imaging modality in the
hands of an SOF Medic?

Join us at SOFsono.org for further case discussion.

Keywords: sonography; injury, hand

Mr Urbaniak is a medical professional within the Polish
Armed Forces.
Dr Hampton is an emergency physician, and a volunteer sub-
ject matter expert ultrasound instructor for the military medi-
cal community. E-mail: katarzyna.hampton@gmail.com.

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