Presentation
Pain and swelling at the palm. History of previous trauma 2 months ago.
Patient Data
The palmar ulnar bursa is distended by fluid signal eliciting low signal at T1 and being of high signal at T2 and STIR WI with synovial thickening and intense post contrast enhancement, it envelops the flexor digitorum profunda and superficialis tendons (at the level of the metacarpal shafts), it extends proximally through the carpal tunnel to the distal forearm while distally it extends along the flexor tendon sheaths of the 3rd and 5th fingers.
The palmar bursa shows constriction at the carpal tunnel giving "hourglass" or figure of eight" configuration.
Case Discussion
Causes of plamar bursitis:
- Infectious (commonly bacterial (staphylococcal, streptococcal or less commonly mycobacterium) secondary to puncture or bite wounds, spread from adjacent infection or rarely hematogenous
- Non infections inflammatory (e.g rheumatoid, gout , CPPD, sarcoidosis)