Palmar ulnar bursa haematoma

Case contributed by Dr Dalia Ibrahim

Presentation

Hand trauma followed by hand swelling. A marker was applied to the site of the swelling.

Patient Data

Age: 14
Gender: Male
MRI

The palmar ulnar bursa is distended by hemorrhagic signal eliciting high signal at T1 and being of high signal at T2 and STIR WI with no significant post contrast enhancement, it envelops the flexor digitorum profunda and superficialis tendons of the 2nd to the 5th fingers, it extends proximally to the carpal tunnel region and extends distally for a short distance along the flexor tendon sheath of the 5th fingers.

Transverse fracture traverses the hook of hamate, vertical fracture passes through the capitate.

Diffuse marrow edema signal is seen n involving the distal row of the carpal bones (namely the trapezium, trapezoid, capitate, hamate and to less extent scaphoid bones) as well as bases of the 3rd & 4th metacarpal bones.

The abductor pollices brevis muscle shows mild edema signal.

Annotated image

Palmar  bursal hematoma

MRI

Follow up MRI performed 2 months later

Total resolution of  the previously noted ulnar  bursa hematoma.

Still noted capitate and hook of hamate fractures.

Regresion of the previously noted marrow edema of the carpal bones.

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Case information

rID: 33362
Case created: 8th Jan 2015
Last edited: 21st Jun 2016
Inclusion in quiz mode: Included

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