title: Lead "bursogram" and focal synovitis secondary to a retained intraarticular bullet fragment.
abstract: We present an unusual case in which retained lead bullet in the wrist joint dissolved and migrated into a synovial recess, producing reactive focal synovitis. The clinical presentation suggested a soft tissue mass or ganglion cyst. The radiologic findings of dense metallic fragments within a recess of the wrist joint established the correct diagnosis and excluded other causes of soft tissue masses. Radiologic recognition of retained intra-articular lead fragments is important, as the clinical features of systemic lead intoxication, lead arthopathy, or reactive focal synovitis may be subtle or misleading.
authors.affiliation: San Francisco Magnetic Resonance Center, CA 94118-1944, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Janzen
authors.forename: P F
authors.initials: PF
authors.lastname: Tirman
authors.forename: A E
authors.initials: AE
authors.lastname: Rabassa
authors.forename: S
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D002061:Bursa, Synovial / Q000000981:diagnostic imaging*; D005549:Foreign-Body Reaction / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007854:Lead; D008297:Male; D011859:Radiography; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D014948:Wounds, Gunshot / Q000150:complications; D014954:Wrist Injuries / Q000150:complications; D014955:Wrist Joint / Q000000981:diagnostic imaging*
chemical_list: D007854:Lead