The carpal boss: an overview of radiographic evaluation.

Abstract

The carpal boss, an unmovable bony protuberance, is located on the dorsum of the wrist at the base of the second and third metacarpals adjacent to the capitate and trapezoid bones. This bony prominence may represent degenerative osteophyte formation and/or the presence of an os styloideum, an accessory ossification center that occurs during embryonic development. When this condition is symptomatic, patients present with complaints of pain and limitation of motion of the affected hand. The symptoms of carpal boss may result from an overlying ganglion or bursitis, an exterior tendon slipping over this bony prominence, or from osteoarthritic changes at this site. Radiographically, the view that best profiles the separate os styloideum is a lateral view utilizing 30 degrees of supination and ulnar deviation of the wrist. Once a diagnosis has been made, treatment can range from the use of nonsteroidal antiinflammatory medication and limited use of the wrist to surgical excision of the anatomic abnormality.

MRI diagnosis of carpal boss and comparison with radiography

“…Symptomatic carpal boss is mostly found in the dominant hand (2,25), although that finding was not confirmed in our series.…”

Achados de imagem por tomografia computadorizada e ressonância magnética do os styloideum em atleta sintomático

“…Among the differential diagnoses, fracture of the base of the second and third metacarpal bones, osteophytes (osteoarthrosis), exostosis, bone and soft tissue neoplasias and cystic bony lesions are highlighted (3,5) . According to Conway et al, os styloideum was firstly described in 1725 by Saltzmann (6) , but the term carpal boss was proposed by Fiolle in 1931 (7) . styloideum, studies involving the use of this method for this purpose are still scarce in the literature (3,4) .…”

Verletzungen der Hand durch Kampfsport

“…Neben einer Standard-a.p.-Aufnahme der Hand und des Handgelenks sollte eine modifizierte seitliche Aufnahme ("carpal boss view") des Handgelenks mit flektierter und 30-40° supinierter Hand sowie 20-30° Ulnardeviation angefertigt werden [5]. Hier stellt sich die knöcherne Masse als dorsaler Überstand ohne Sklerosierungszeichen des Gelenks dar.…”