Carpometacarpal bossing (or metacarpal/carpal bossing) is a small, immovable mass of bone on the back of the wrist. The mass occurs in one of the joints between the

carpus In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal ...

and

metacarpus In human anatomy, the metacarpal bones or metacarpus form the intermediate part of the skeletal hand located between the phalanges of the fingers and the carpal bones of the wrist, which forms the connection to the forearm. The metacarpal bones ...

of the

hand A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "h ...

, called the

carpometacarpal joint The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones. The CMC joint of the thumb or the first CMC joint, also known as the trapeziometacar ...

s, where a small immovable protuberance occurs when this joint becomes

swollen Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...

or bossed. The joint between the index metacarpal and the capitate is a fibrous non-mobile joint. Some people have a gene that leads to this growth. It looks like arthritis (bone spurs on each side of the joint) on X-ray. It looks like a ganglion on the hand, but more towards the fingertips.

Clinical significance

The carpometacarpal joint is usually found at the base of the second and third

metacarpal In human anatomy, the metacarpal bones or metacarpus form the intermediate part of the skeletal hand located between the phalanges of the fingers and the carpal bones of the wrist, which forms the connection to the forearm. The metacarpal bones ...

bones at the point where they meet the small bones of the

wrist In human anatomy, the wrist is variously defined as (1) the Carpal bones, carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known ...

. Bosses are usually painless and will never cause more than a slight ache. They tend to be of manageable size, but on occasion the extensor tendons can slide over the bump, which can be annoying. Sometimes there is a ganglion cyst along with the boss. Often, this condition will be mistaken for a

ganglion cyst A ganglion cyst is a fluid-filled bump associated with a joint or tendon sheath. It most often occurs at the back of the wrist, followed by the front of the wrist. Onset is often over several months, typically with no further symptoms. Occasional ...

because of its location and external appearance. Carpometacarpal boss is uncommon and there is not much scientific data. Its etiology has yet to be fully defined, but can be congenital in the form of an accessory ossicle (os styloideum) or may be acquired from trauma, repetitive use, or degenerative osteophytosis. The condition usually begins to show in the 3rd or 4th decade.

Additional images

References

External links

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About.com: Orthopedics - Bossing

Carpal Boss: An Overview of Radiographic Evaluation
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Upper limb anatomy