HSS Ultrasound of the Month Case 157

Clinical History 62 year old female with volar sided wrist pain.

Ultrasound of the Month – Case 157

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Ultrasound of the Month – Case 157

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Diagnosis: Wrist Ulnar and Radial Bursitis The radial and ulnar bursae are synovium-lined structures that track along the flexor tendons of the wrist and hand at the level of the wrist, often communicating with the tendon sheaths that are found along these tendons at the level of the fingers.

The radial bursa tracks along the flexor pollicis longus tendon, while the ulnar bursa has three invaginations that track along the flexor digitorum superficialis and profundus tendons in the carpal tunnel.

Just like tendon sheaths, these bursae can become inflamed in patients with inflammatory arthritides, and can be a mode of spread of infection, such as mycobacterial infections.

Ultrasound is an excellent modality for identifying fluid in these bursae.

Presence of hyperemia on power or color Doppler suggests active inflammation, and ultrasound is also excellent for safely guiding aspirations or injections of these bursae.

Ultrasound of the Month – Case 157

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