What is the cause of a spontaneous hematoma on the hand with a palpable lump?

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Last updated: April 15, 2025View editorial policy

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Differential Diagnosis for Spontaneous Hematoma on Hand with Lump

  • Single most likely diagnosis
    • Hematoma due to trauma: This is the most likely diagnosis as spontaneous hematomas are often caused by minor trauma that the patient may not even remember, and the presence of a lump supports this diagnosis.
  • Other Likely diagnoses
    • Bleeding disorder (e.g., hemophilia, von Willebrand disease): These conditions can cause spontaneous bleeding and hematoma formation, even with minor trauma.
    • Anticoagulant use: Patients on anticoagulant medications (e.g., warfarin, aspirin) are at increased risk of bleeding and hematoma formation.
    • Vascular malformation: Abnormalities in blood vessel structure, such as arteriovenous malformations, can cause spontaneous bleeding and hematoma formation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Malignancy (e.g., soft tissue sarcoma): Although rare, a spontaneous hematoma with a lump could be a sign of an underlying malignancy, which would require prompt diagnosis and treatment.
    • Infection (e.g., abscess): A spontaneous hematoma could be a sign of an underlying infection, such as an abscess, which would require prompt antibiotic treatment.
    • Aneurysm or pseudoaneurysm: A spontaneous hematoma could be a sign of an underlying aneurysm or pseudoaneurysm, which would require prompt surgical intervention.
  • Rare diagnoses
    • Amyloidosis: This condition can cause spontaneous bleeding and hematoma formation due to the deposition of abnormal proteins in blood vessel walls.
    • Scurvy: Vitamin C deficiency can cause spontaneous bleeding and hematoma formation due to impaired collagen synthesis.
    • Ehlers-Danlos syndrome: This genetic disorder can cause spontaneous bleeding and hematoma formation due to defects in blood vessel structure.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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