Ultrasound-Driven Diagnosis of Hamate Hook Stress Fracture in Athlete: A Case Report.

Abstract

BACKGROUND Early diagnosing a stress fracture of the hook of the hamate is challenging with plain X-rays alone. However, it is necessary to determine the appropriate treatment method to allow athletes to return to sports as soon as possible. We present a case in which diagnosis of stress fracture of the hook of the hamate in a professional baseball player was confirmed on the day of injury by ultrasound imaging, and early intervention was performed. CASE REPORT The patient was a 22-year-old male professional baseball player. During hitting practice, he experienced pain in his right palm, then tenderness around the hook of the hamate was noted. Ultrasonography revealed disruption of the bony cortical continuity of the ulnar aspect of the hook of the hamate and a hematoma around this lesion. Stress fracture of the hook of the hamate was confirmed by computed tomography. Resection of the hook of the hamate was performed on the third day after injury. The patient returned to playing baseball 3 months after surgery. CONCLUSIONS In stress fracture of the hook of the hamate, the time required for diagnosis greatly affects the time to return to competition. To solve this clinical issue, ultrasonography was applied to the early diagnosis of stress fractures of the hook of the hamate. This study suggests that ultrasound can be a useful diagnostic tool for early diagnosis of stress fractures of the hook of the hamate.