A small bursa over the dorsal aspect of the proximal interphalangeal joint, between the extensor mechanism and the underlying joint capsule. It reduces friction as the central slip of the extensor mechanism glides over the PIP joint during flexion and extension.
PIP joint dorsal bursitis presents as a dorsal PIP joint swelling indistinguishable from PIP joint synovitis without ultrasound. Chronic pressure from occupational gripping produces bursitis in manual workers. In rheumatoid arthritis, dorsal PIP bursitis accompanies the boutonniere deformity as the central slip becomes attenuated. Ultrasound distinguishes dorsal bursal fluid from intra-articular PIP effusion.
Bursal swelling over the dorsal PIP joint from repetitive grip trauma or inflammatory arthritis, distinguishable from joint synovitis by ultrasound and managed with splinting and injection.
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