Adam Johnson's 17th-minute strike was enough to hand Sunderland a win which, coupled with West Ham's failure to emerge from their trip to Chelsea with an unlikely victory, lifted them out of the bottom three for the first time since August.
However, they needed a superb 39th-minute save by keeper Vito Mannone and then six minutes from time, the crossbar to deny Ryan Shawcross an equaliser.
Mark Hughes: "We are disappointed, obviously, that a performance of real character and desire and determination and no little skill has got no reward.
"Unfortunately on too many occasions this season, we have been hurt by refereeing decisions that have had a marked effect on the outcome of the game.
"We are talking once again about a situation that I feel was a poor decision from the referee.
"It was difficult for him because I felt the lad Altidore went down very easily looking for an advantage and I felt on the night, too much of that was going on, to be perfectly honest.
"The referee has got to be able to look through that and understand what is happening. He wasn't very good in that regard and as a consequence, he bought a challenge where there was very minimal contact.
"The lad went down easily and the referee deemed fit to give Steven a second yellow card for that challenge, which is unbelievable from my point of view.
"I was really pleased with how we played, but there are too many occasions where we are having mountains to climb to enable us to win football matches.
"All we ask is that we have a level playing field and the key decisions are made correctly because when you have two sides going against each other, you want the best team to win and unfortunately, the best team didn't win."