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Radial Bursa of the Hand

bursa radialis manus

The radial bursa of the hand is the synovial sheath of the flexor pollicis longus tendon, extending from approximately 2 cm proximal to the wrist flexor retinaculum to the distal phalanx of the thumb. Unlike the digital sheaths of the fingers, the radial bursa is a continuous sheath from the forearm to the thumb tip because the FPL tendon does not leave its sheath at the level of the palm.

Region: Hand & Wrist

Clinical Relevance

Clinical Notes

The radial bursa communicates with the ulnar bursa in approximately 50-80% of individuals, which is the anatomical basis for horseshoe abscess formation where infection spreads between the thumb and small finger tendon sheaths. In de Quervain tenosynovitis, the first dorsal compartment (APL and EPB) is inflamed at the radial styloid, not the radial bursa proper. The radial bursa is directly accessed during thumb FPL tendon surgery at the wrist.

Pathology

Common Injuries & Conditions

FPL Tendon Sheath Infection

Penetrating injury to the thumb pulp or palmar thumb can infect the radial bursa, producing Kanavel signs along the entire thumb and potentially spreading to the ulnar bursa through their communication, requiring urgent surgical drainage and irrigation.