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Topic

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Adipose tissue (hand)

Adipose tissue in the fingers and hand forms an essential component of the subcutaneous layer, the digital pulp, and the palmar fat compartments. It provides cushioning, distributes mechanical loads, protects underlying tendons, nerves, and vessels, and supports fine tactile function—especially in the distal phalanges.

In the fingertips, adipose tissue is divided into small lobulated fat chambers separated by strong fibrous septa, creating the characteristic firmness of the digital pad. This structure stabilizes the skin during grasping and pinching and reduces shear forces. On the dorsum of the hand, adipose tissue is thinner and more mobile, whereas on the palm it is thicker, more fibrous, and tightly anchored to the palmar fascia.

Synonyms

  • Subcutaneous fat of the hand

Location and Structure

  • Fingers:

    • Distal pulp contains dense, lobulated adipose chambers bound by collagenous septa.

    • Palmar aspect contains thick, fibrous fat pads tightly attached to skin.

    • Dorsal aspect contains thin, loose adipose tissue.

  • Hand:

    • Palmar fat is partitioned by fibrous septa attached to palmar aponeurosis.

    • Thenar and hypothenar regions contain specialized adipose compartments.

  • Composition:

    • Mature unilocular adipocytes with surrounding collagen bundles.

    • Richly vascularized and sensitive to pressure, trauma, and inflammation.

Relations

  • Dorsally: Extensor tendons and dorsal skin

  • Palmarly: Palmar aponeurosis, flexor tendons, tendon sheaths

  • Laterally: Digital nerves and arteries

  • Distally: Nail bed and fingertip skin

  • Proximally: Fibrous septa connecting to bone and fascia

Function

  • Provides cushioning against impact and mechanical stress

  • Stabilizes the fingertip during grip and fine manipulation

  • Allows load distribution during pinching and pressing

  • Protects digital vessels, nerves, and tendons

  • Maintains thermal insulation and supports vascular perfusion

MRI Appearance

T1-weighted images:

  • Adipose tissue exhibits bright high signal intensity

  • Lobulated pulp fat clearly separated by low-signal fibrous septa

  • Palm and dorsum fat sharply contrast with intermediate-signal muscle and tendons

  • Excellent for identifying fat pad volume loss or displacement

T2-weighted images:

  • Adipose tissue remains bright, though slightly less intense than on T1

  • Fibrous septa appear as thin dark lines

  • High contrast between fat and surrounding soft tissues

STIR:

  • Normal fat becomes dark to intermediate due to fat suppression

  • Fibrous septa remain low signal

  • Highlights non-fat components by suppressing adipose signal

T1 Fat-Saturated Post-Contrast

  • Fat signal fully suppressed; adipose tissue appears dark

  • No intrinsic enhancement of fat

  • Enhancing structures (vessels, inflamed soft tissue) stand out clearly against suppressed fat

  • Useful for detecting:

    • Subtle inflammation

    • Scar tissue

    • Granulation tissue

    • Post-traumatic changes

CT Appearance

Non-Contrast CT:

  • Adipose tissue shows low attenuation (–80 to –120 HU)

  • Digital pulp visible as well-defined fat lobules separated by thin soft-tissue septa

  • Dorsal fat is thinner and less structured

MRI image

Adipose tissue hand MRI axial image-img-00000-00000