Pulsatile masses are mostly suggestive of vascular lesions or closely related to blood vessels. Imaging examinations such as angiography and blood flow ultrasound can clearly localize, quantify and qualify the diagnosis, and provide detailed information about the blood supply and its relationship with the surrounding great vessels. A pulsating mass on the clavicle is the clinical manifestation of peripheral aneurysm. Peripheral aneurysms are aneurysms that occur in each of the main arteries, such as the carotid and extremity arteries. The differential diagnosis of a pulsatile mass forming in a wound: 1. Acute arteriovenous Fistulae may appear immediately after injury or after dissolution of the clot outside the arteriovenous communication, with a hematoma localized to the injury and, in the majority of cases, with tremors and murmurs. In most patients, arterial pulsation is still palpable in the limb distal to the arteriovenous fistula, but is weaker than on the healthy side. In the case of superficial femoral artery with deep femoral artery injury in the lower extremity, no pulsation of the dorsalis pedis artery can be detected and there are symptoms of limb ischemia. In chronic arteriovenous fistula, the patient has swelling, numbness, pain, and weakness in the affected limb. There is a local humming sound in the pulsatile mass. Heart failure may have chest tightness, palpitations, and shortness of breath. Regardless of the size of the arteriovenous fistula, a typical, rough and continuous rumbling sound called “machine-like” murmur can be heard in the arteriovenous fistula site. The murmur increases during cardiac systole and travels proximally and distally along the main vessels. This murmur is distinguished from the faint diastolic murmur caused by a pseudoaneurysm and the systolic murmur caused by arterial stenosis. 2. Increased pulse rate This is the result of the Braibridge reflex due to increased venous return to the heart or increased cardiac workload due to decreased mean arterial pressure (Marey’s law). 3. Heart enlargement and heart failure Due to the rapid flow of large amounts of blood through the fistula into the veins, the venous pressure increases and the amount of blood returned to the heart increases, causing heart enlargement. Progressive enlargement of the heart can lead to heart failure. The degree of heart enlargement and heart failure is closely related to the size and location of the fistula and the length of time it has been in place. Pate reported that arteriovenous fistulas occurring in direct branches of the aorta can cause heart failure as early as 6 weeks after trauma, and in the majority of limb arteriovenous fistulas, localized pain, ascites, and abdominal pain were present early after surgery in 9 cases of arteriovenous fistulas that occurred during cardiac resection. Pain, ascites and abdominal pain symptoms. 4. Elevated local temperature The surface skin temperature of the involved limb is elevated at the site of the arteriovenous fistula, while the skin temperature may be normal or below normal in the more distant parts of the arteriovenous fistula. 5.Venous insufficiency Direct traffic between arteries and veins increases venous elevation. In most patients, the superficial veins near or distal to the arteriovenous fistula are dilated and curved. Skin pigmentation is accompanied by cellulitis of the lower legs, and ulcers often occur in the toes or fingers, showing symptoms similar to those following deep phlebitis. The disease is mostly caused by trauma, so there are no effective preventive measures, while for some medical injuries such as splenectomy and nephrectomy with large ligation of the splenic and renal tips; ligation of the femoral artery during amputation; and thyroidectomy, the health care provider is required to carefully examine the patient after surgery to prevent the occurrence of arteriovenous fistula.