Advertisement

Recurrent Hematoma in the Finger and Leg: Achenbach Syndrome

      A 35-year-old woman presented with sudden pain, edema, and bruising in her right second finger. There was no history of trauma or other causative triggers, such as cold exposure, stress, or medication. The patient was a nonsmoker with no significant medical history. On physical examination, her second finger showed a subcutaneous hematoma distal to the metacarpophalangeal joint on the palmar and dorsal sides, and the range of motion of the affected finger was slightly restricted because of swelling (Figure A). The finger was warm, capillary refilling was normal, and there was no sensory disturbance. Blood test results showed a normal platelet count and no coagulopathy. When she returned for a follow-up visit 1 week later, her symptoms had already resolved spontaneously without treatment. A detailed medical history revealed that the patient had experienced the same symptoms several times per year for a couple of years. The symptoms were usually located in the second or third fingers and less frequently in the lower legs (Figure B). In all cases, the pain was accompanied by edema, and coloration change occurred within minutes to hours of onset and resolved spontaneously within 1 week. A clinical diagnosis of Achenbach syndrome was thus established.
      Figure
      Figure(A) Subcutaneous hematoma and swelling in the right second finger. (B) Subcutaneous hematoma in the right lower leg.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Achenbach W.
        Das paroxysmale Handhämatom.
        Medizinische. 1958; 52: 2138-2140
        • Kordzadeh A
        • Caine PL
        • Jonas A
        • Rhodes KM
        • Panayiotopolous YP
        Is Achenbach's syndrome a surgical emergency? A systematic review.
        Eur J Trauma Emerg Surg. 2016; 42: 439-443https://doi.org/10.1007/s00068-015-0610-0
        • Godoy A
        • Tabares AH.
        Achenbach syndrome (paroxysmal finger hematoma).
        Vasc Med. 2019; 24: 361-366https://doi.org/10.1177/1358863X19849627
        • Jiménez PR
        • Ocampo MI
        • Castañeda-Cardona C
        • Rosselli D.
        Achenbach's syndrome: case report and systematic review of the literature.
        Revista Colombiana de Reumatología (English Edition). 2017; 24: 230-236
        • Cohen SN.
        Personal observation of Achenbach syndrome.
        Clin Exp Dermatol. 2018; 43: 933-934https://doi.org/10.1111/ced.13661
        • Young B
        • Okera S.
        Recurrent subconjunctival haemorrhage in Achenbach's syndrome.
        Clin Exp Ophthalmol. 2018; 46: 965-966https://doi.org/10.1111/ceo.13314
        • Yamada T.
        Achenbach's syndrome in an elderly woman.
        J Gen Fam Med. 2018; 19: 65-66https://doi.org/10.1002/jgf2.158
        • Notomi K
        • Harada T.
        Achenbach syndrome.
        CMAJ. 2019; 191: E584https://doi.org/10.1503/cmaj.181293