Tendon Sheath, Bursae, and Clinically Relevant Peritendinous Structures of the Hand and Wrist

Imaging is essential for evaluating tenosynovitis, bursitis, and pulley lesions. Both ultrasound (US) and MR imaging detect fluid accumulation and synovial thickening, key for diagnosing tenosynovitis and bursitis. They also reveal A1 pulley thickening in trigger fingers and A2-A4 pulley strain or tears in closed flexor pulley injuries (climber's fingers). US enables dynamic assessments in real-time and detects hypervascularity, while MR imaging provides detailed insights into the extent of inflammation in the soft tissues and bone through fluid-sensitive sequences and contrast enhancement. These complementary modalities enhance diagnostic accuracy, providing better guidance for treatment and interventional procedures.