Ultrasound of the Gruberi Bursa With Cadaveric and MRI Correlation

Abstract

The Gruberi bursa characteristically is located between the EDL and the talus; on ultrasound, the Gruberi bursa is most commonly unilocular, anechoic, and compressible.

Contrast-enhanced magnetic resonance imaging (MRI) features of Gruberi Bursitis as a very rare cause of dorsolateral ankle pain and swelling: Case report and review of the literature

“…MRI and US examination tools are frequently used for additional evaluation of clinically suspected bursal inflammation, and abnormal fluid around the ankle on imaging may be a source of symptoms. Fluid can be seen in tendon sheaths and joints, as well as focal fluid in ganglion cysts and bursae [1] .…”

“…The Gruberi sinus tarsi bursa is an anatomic bursa in the dorsolateral ankle that has been described but is rarely mentioned in the contemporary radiology literature [1] . The Gruberi bursa was first described by Alexander Monro (1773-1859) as "a bursa mucosa for the tendons of the extensor digitorum communis longus, between them and the tibia and ligament of the ankle" [3] .…”

“…Similar references to this bursa can be found in several early twentieth-century anatomy textbooks, which defined the Gruberi sinus tarsi bursa's anatomical location between the dorsolateral aspect of the neck of the talus bone and the EDL tendon [ 3 , 4 ]. Furthermore, a potential communication between the bursa and the talonavicular joint has also been described [2] , but none has been described between the bursa and the tibiotalar joint [1] . Jones [5] in 1949 claims that the bursa never communicates with the EDL tendon sheath, whereas a recent work by Kelikian and Sarrafian [6] stated that the bursa can communicate with the talonavicular joint, the tibiotalar joint, and the EDL tendon sheath.…”

“…The Gruberi sinus tarsi bursa is an anatomic bursa located in the dorsolateral ankle, that is rarely mentioned in recent radiology literature. The Gruberi bursa is characteristically found between the extensor digitorum longus (EDL) tendons and the talus and 98% of the fluid collections identified on ultrasound (US) were unilocular, 94% were anechoic and 89% were found to be compressible, with the latter finding being more than coincidental [1] .…”

The frondiform ligament sling: a sonographic landmark for injection into the sinus tarsi

“…The frondiform ligament is a readily demonstrable landmark on ultrasound that can be used to identify the sinus tarsi with confidence. Visualisation of it can be aided by distension of the gruberi bursa; a bursa that extends from the sinus tarsi along the frondiform ligament (between the talus and EDL) [14]. The degree of bursal distension and subsequent extension along the frondiform ligament can be so significant that it can mimic tenosynovitis of the EDL tendon [5].…”