Goiney Christopher, Porrino Jack, Richardson Michael L, Mulcahy Hyojeong, Chew Felix S
Department of Radiology, University of Washington, Seattle, Washington.
J Wrist Surg. 2017 Feb;6(1):22-32. doi: 10.1055/s-0036-1583941. Epub 2016 May 9.
The carpal boss is an osseous protuberance occurring variably along the dorsum of the second or third metacarpal base, lacking a standardized definition. We sought to characterize the dorsal second and third carpometacarpal joints in the general population on computed tomography (CT) to better define this variant anatomy. A total of 129 wrist CT studies were reviewed. Note was made of the dorsal second/third carpometacarpal osseous anatomy, the presence of regional bursitis or tenosynovitis, and relationship of the extensor carpi radialis brevis attachment to the base of the third metacarpal. Out of the 129 wrists, 106 (82.2%) demonstrated a dorsal protuberance arising from the base of the third metacarpal, in isolation. Out of the 129 wrists, 14 (10.9%) lacked a dorsal protuberance or nonunited ossicle at the level of the second or third carpometacarpal joint. Out of the 129 wrists, 9 (7%) wrists demonstrated more complex anatomy-8 wrists (6.2%) with a dorsal protuberance at the base of the third metacarpal seen in combination with an adjacent nonunited ossicle and/or dorsal protuberance arising from the capitate, and 1 wrist (0.8%) with an isolated ossicle at the base of the third metacarpal. Of these nine wrists, eight (6.2%) demonstrated arthritis at the resultant pseudoarticulation(s). The majority of wrists demonstrated an isolated protuberance arising from the dorsal base of the third metacarpal, with a small minority with a nonunited ossicle at this level and/or dorsal protuberance of the capitate. The presence of secondary arthritis (8 out of 129 wrists, 6.2%) may reflect a pain generator. Cross-sectional study; level 2.
腕部隆突是沿着第二或第三掌骨基底背侧出现的骨性突起，目前尚无标准化的定义。我们试图通过计算机断层扫描（CT）对普通人群的第二和第三腕掌关节背侧进行特征描述，以更好地界定这种变异解剖结构。共回顾了129例腕部CT研究。记录第二/三腕掌关节背侧的骨性解剖结构、局部滑囊炎或腱鞘炎的存在情况，以及桡侧腕短伸肌附着点与第三掌骨基底的关系。在129例腕部中，106例（82.2%）表现为孤立的、源自第三掌骨基底的背侧突起。在129例腕部中，14例（10.9%）在第二或第三腕掌关节水平缺乏背侧突起或未愈合的小骨。在129例腕部中，9例（7%）表现出更复杂的解剖结构——8例（6.2%）在第三掌骨基底有背侧突起，同时伴有相邻的未愈合小骨和/或源自头状骨的背侧突起，1例（0.8%）在第三掌骨基底有孤立的小骨。在这9例腕部中，8例（6.2%）在形成的假关节处出现关节炎。大多数腕部表现为源自第三掌骨背侧基底的孤立突起，少数在该水平有未愈合的小骨和/或头状骨的背侧突起。继发性关节炎的存在（129例腕部中有8例，6.2%）可能是疼痛的根源。横断面研究；2级。
