443HAND ARM VIBRATION SYNDROME: A BRIEF CASE-BASED REVIEW OF THE LITERATUREProlonged exposure to hand-transmitted vibration is associated with an increased occurrence of symptoms and signs of disorders in the vascular, neurological and osteoarticular systems of the upper limbs. Skin changes and nail involvement, due to either central or peripheral nerve compression or damage, are also well recognized, and are reported in other destructive conditions such as trauma, peripheral vascular disease, Raynaud’s phenomenon, radiotherapy, and primary interphalangeal osteoarthritis of the hand. We presented the case of a 50 years old-man who is a forestry worker over 20 years and using chain saw over 10 years and gasoline engined hand-held lawn mower for 2 years. His complaints were paresthesia, pricking, tingling, numbness at first three fingers of both hands, and stiffness and joint pain at all fingers. He had white fingers, pterygium of nails and radiological evidence for osteoarthritis, but no evidence for systemic diseases. Comorbidities presented by our patient suggests a common pathophysiological basis for all the diseases, however, determining the exposure-response relationships is difficult. We tried to review the literature for overview our knowledge about hand arm vibration syndrome. A PubMed search was performed for studies relating to hand arm vibration syndrome from 1990 to 2015. Publications were retrieved by using search terms for hand arm vibration, white finger, nail disorder and osteoarthritis. Relevant references from these studies were also retrieved. No filters were applied to limit the retrieval by study type. ilkerilhanli@hotmail.comResearch612016Vibration,White finger,Carpal tunnel syndrome,Osteoarthritis,PterygiumIlker Ilhanli,Kivanc Cengiz,Yunus Durmaz,Erhan Arslan,Canan CelikDepartment of Physical Medicine and Rehabilitation, School of Medicine, University of Giresun, Giresun, Turkey. ,Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Sivas Numune Hospital, Sivas, Turkey,Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Mehmet Akif Inan Training and Research Hospital, Sanlıurfa, Turkey.,Department of Neurosurgery, School of Medicine, University of Giresun, Giresun, Turkey,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Giresun, Giresun, Turkey.