Duplex-Guided Diagnosis and Surgical Repair of a Posterior Circumflex Humeral Artery Aneurysm in a Major League Baseball Pitcher

Abstract

Aneurysms involving the third portion of the axillary artery and its branches have been reported in baseball pitchers and in other overhead-throwing athletes. The abnormality can vary from intermittent compression to axillary artery thrombosis and formation of an aneurysm. Patients presenting with symptoms secondary to an axillary artery injury, like upper extremity weakness, require rapid and precise diagnosis. Moreover, accurate identification of the arterial pathology helps guide necessary surgical therapy. Previous reports have made the diagnosis from physical examination, noninvasive studies, and additional, invasive studies, such as arteriography. In this case, a young healthy major league baseball pitcher was referred for hand numbness and a suspected axillary artery aneurysm. We were able to confirm the physical examination abnormalities with arterial duplex only and make an operative plan on the basis of the ultrasound findings.