The flexor carpi radialis tendon sheath is the synovial sleeve around the FCR tendon where it passes through its own narrow tunnel in the flexor retinaculum and along the groove of the trapezium. It lets the tendon glide as it turns to reach the base of the second metacarpal, and inflammation here (FCR tenosynovitis) causes pain on the palm side of the wrist below the thumb.
| Location | Front of the wrist on the thumb side, in the separate tunnel through the flexor retinaculum and along the groove of the trapezium |
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Lets the FCR tendon glide in its tight tunnel as it turns toward the base of the second metacarpal. Tenosynovitis here causes pain at the base of the thumb side of the wrist.
FCR wrist bursitis presents as palmar radial wrist pain reproduced by resisted wrist flexion and radial deviation. The fibro-osseous tunnel at the wrist is uniquely prone to tendinopathy and bursitis due to the acute angle the tendon takes around the trapezium ridge. Ultrasound demonstrates peritendinous fluid in this tunnel. Surgical release of the FCR tunnel is effective for refractory FCR tendinopathy and bursitis.
Painful bursal and tendon inflammation in the FCR fibro-osseous wrist tunnel producing radial palmar wrist pain with wrist flexion, managed by injection or surgical tunnel release.
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