Imaging of the bursae - PubMed (original) (raw)

Imaging of the bursae

Zameer Hirji et al. J Clin Imaging Sci. 2011.

Abstract

When assessing joints with various imaging modalities, it is important to focus on the extraarticular soft tissues that may clinically mimic joint pathology. One such extraarticular structure is the bursa. Bursitis can clinically be misdiagnosed as joint-, tendon- or muscle-related pain. Pathological processes are often a result of inflammation that is secondary to excessive local friction, infection, arthritides or direct trauma. It is therefore important to understand the anatomy and pathology of the common bursae in the appendicular skeleton. The purpose of this pictorial essay is to characterize the clinically relevant bursae in the appendicular skeleton using diagrams and corresponding multimodality images, focusing on normal anatomy and common pathological processes that affect them. The aim is to familiarize radiologists with the radiological features of bursitis.

Keywords: Bursae; computed tomography; imaging; interventions; magnetic resonance; ultrasound.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1

Figure 1

Diagram of normal bursae surrounding the shoulder joint: (1) subacromial-subdeltoid bursa, (2) subscapular recess, (3) subcoracoid bursa, (4) coracoclavicular bursa, (5) supra-acromial bursa and (6) medial extension of subacromial-subdeltoid bursa.

Figure 2

Figure 2

Coronal magnetic resonance arthrogram depicting gadolinium in the SASD bursa from a full-thickness rotator cuff tear.

Figure 3

Figure 3

Transverse ultrasound image of the rotator cuff depicting acute subacromial-subdeltoid bursitis.

Figure 4

Figure 4

(a) Line diagram and (b) corresponding magnetic resonance arthrogram of the subcoracoid bursa.

Figure 5

Figure 5

Line diagram showing the superficial and deep infrapatellar bursae. (1) Superficial infrapatellar bursa, (2) deep infrapatellar, femur (F), Hoffa's fat pad (HF), patella (P), patellar tendon (PT) and tibia (T).

Figure 6

Figure 6

Sagittal magnetic resonance T2 fat sat image depicting the superficial infrapatellar bursa.

Figure 7

Figure 7

Sagittal magnetic resonance T2 gradient showing deep infrapatellar bursal fluid.

Figure 8

Figure 8

Ultrasound in the longitudinal plane showing deep infrapatellar bursal fluid.

Figure 9

Figure 9

Line diagram showing compartmentalization of the prepatellar bursa. SCCT - subcutaneous cellular tissues; QT - quadriceps tendon; PT - patellar tendon; F - femur; P, patella; (1) superficial compartment; (2) intermediate compartment; (3) deep compartment.

Figure 10

Figure 10

Sagittal magnetic resonance T2 fat sat image showing high-signal fluid intensity within the prepatellar bursitis.

Figure 11

Figure 11

Axial magnetic resonance T2 fat sat image depicting Baker's cyst with its neck between the semimembranosus and the medial gastrocnemius tendons. Image also depicts prepatellar bursitis.

Figure 12

Figure 12

Longitudinal ultrasound image demonstrating fluid within the suprapatellar bursa.

Figure 13

Figure 13

Sagittal magnetic resonance T2 gradient image demonstrating fluid within the suprapatellar bursa.

Figure 14

Figure 14

Axial magnetic resonance T2 fat sat image showing semimembranosus bursa.

Figure 15

Figure 15

Coronal magnetic resonance T2 Short TI Inversion Recovery (STIR) image showing semimembranosus bursa.

Figure 16

Figure 16

Sagittal magnetic resonance gradient T2 image showing semimembranosus bursa.

Figure 17

Figure 17

(a) Axial line diagram and (b) axial magnetic resonance image showing pes anserine bursitis

Figure 18

Figure 18

Coronal magnetic resonance T2 fat sat image showing fluid within the medial collateral ligament bursa.

Figure 19

Figure 19

Axial magnetic resonance T2 fat sat image showing fluid within the medial collateral ligament bursa.

Figure 20

Figure 20

Sagittal magnetic resonance T2 fat sat image showing retrocalcaneal bursitis with a thick synovial wall.

Figure 21

Figure 21

Longitudinal ultrasound image showing superficial retrocalcaneal bursa.

Figure 22

Figure 22

(a) Axial magnetic resonance T2 and (b) coronal magnetic resonance T2 STIR images of the left hip demonstrate a fluid-filled structure deep to the iliopsoas muscle in the expected location of the iliopsoas bursa. The iliopsoas tendon can be seen medial to the bursa and the femoral vessels can be seen further medially

Figure 23

Figure 23

Coronal line diagram of the trochanteric bursa overlying the posterior facet of the greater trochanter deep to the gluteus medius tendon.

Figure 24

Figure 24

Coronal magnetic resonance T2 STIR image of the right trochanteric bursitis.

Figure 25

Figure 25

Coronal magnetic resonance T2 STIR image of the bilateral subgluteus medius bursitis, larger on the right side.

Figure 26

Figure 26

Coronal magnetic resonance STIR image of the right subgluteus minimus bursitis.

Figure 27

Figure 27

Line diagram depicting location of the olecranon bursa.

Figure 28

Figure 28

Magnetic resonance T2 fat sat image with fluid in the olecranon bursa.

Figure 29

Figure 29

Longitudinal ultrasound image demonstrating fluid and debris in the olecranon bursa.

Figure 30

Figure 30

(a) Enhanced axial computed tomography of the right iliopsoas bursitis and (b) ultrasound-guided drainage.

Figure 31

Figure 31

(a) Ultrasound- and (b) fluoroscopy-guided trochanteric bursal injection.

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