Krishnamurthy Hejjaji Anand, Gowda Harshith, Parameshwara Pooja Basavaradhya, Raju P Arjun, Mudunuri Saitejas, Parihar Pratapsingh
Radiology, Tenet Diagnostics, Bangalore, IND.
Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 29;16(8):e68078. doi: 10.7759/cureus.68078. eCollection 2024 Aug.
Carpal boss, a relatively rare and often underdiagnosed condition, is characterized by a bony protuberance at the dorsal aspect of the carpometacarpal (CMC) joint. It is commonly misdiagnosed due to its nonspecific clinical presentation, which can mimic other conditions, such as ganglion cysts or fractures. This case series aims to document and analyze the clinical presentations and radiological findings of three patients diagnosed with carpal boss, highlighting the importance of advanced imaging techniques in accurate diagnosis and management. A case series was conducted at Tenet Diagnostics, Bengaluru, Karnataka, involving three patients with dorsal wrist pain and swelling at the CMC joint. All patients underwent clinical evaluation followed by imaging studies using 3T magnetic resonance imaging (MRI) (United Imaging, Shanghai, China) and 32-slice computed tomography (CT) (Siemens Somatom Go; Siemens Healthineers, Munich, Germany). The MRI sequences included T1-weighted and proton density (PD) fat-saturated images, while CT imaging focused on axial and sagittal sections to assess bony structures. All three patients were diagnosed with carpal boss based on imaging findings. MRI revealed hypertrophied bony protuberances at the bases of the second and third metacarpal bones, forming pseudoarthrosis with associated osteoarthritic changes. CT imaging confirmed these findings, providing high-resolution views of the bony abnormalities. Combining MRI and CT was crucial in differentiating carpal boss from other potential diagnoses, such as ganglion cysts or fractures. This case series underscores the importance of advanced imaging modalities, such as MRI and CT, in diagnosing carpal boss. Accurate and early diagnosis can prevent mismanagement and guide appropriate treatment strategies, improving patient outcomes. Increased awareness of carpal boss among clinicians and radiologists is essential for promptly recognizing and managing this condition.
腕掌骨隆突是一种相对罕见且常被漏诊的病症，其特征是腕掌关节背侧出现骨性突起。由于其临床表现不具特异性，可类似其他病症，如腱鞘囊肿或骨折，因此常被误诊。本病例系列旨在记录和分析三名被诊断为腕掌骨隆突患者的临床表现及影像学检查结果，强调先进成像技术在准确诊断和治疗中的重要性。在印度卡纳塔克邦班加罗尔的特尼特诊断中心开展了一项病例系列研究，涉及三名腕关节背侧疼痛且腕掌关节肿胀的患者。所有患者均接受了临床评估，随后使用3T磁共振成像（MRI）（中国上海联影）和32层计算机断层扫描（CT）（西门子Somatom Go；德国慕尼黑西门子医疗）进行影像学检查。MRI序列包括T1加权像和质子密度（PD）脂肪抑制像，而CT成像重点关注轴位和矢状位断面以评估骨质结构。根据影像学检查结果，所有三名患者均被诊断为腕掌骨隆突。MRI显示第二和第三掌骨基部有肥大的骨性突起，形成假关节并伴有骨关节炎改变。CT成像证实了这些发现，提供了骨质异常的高分辨率图像。将MRI和CT相结合对于区分腕掌骨隆突与其他可能的诊断，如腱鞘囊肿或骨折至关重要。本病例系列强调了MRI和CT等先进成像方式在诊断腕掌骨隆突中的重要性。准确和早期诊断可避免治疗不当并指导适当的治疗策略，改善患者预后。临床医生和放射科医生提高对腕掌骨隆突的认识对于及时识别和处理这种病症至关重要。
