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Overuse and traumatic injury concerning a carpal boss is not exceptional, and unenhanced MRI is an optimal modality for recognizing bone marrow oedema (BME), soft-tissue injury, and anatomical differences.
As per a recent
study conducted by the investigators of Sidney Kimmel Medical College, bone
marrow oedema (BME) at an os styloideum or the carpal boss is a consistent MRI
finding among individuals with the dorsal wrist. The MRI is proven to be an
ideal approach to validate BME. The primary aim of this study was to assess
patterns of MRI findings linking carpal boss and extensor carpi radialis brevis
(ECRB) tendon insertion within people with post-traumatic or overuse-related
wrist pain.
A total of 84 MRI
cases with carpal bossing from December 2006 to June 2015 were selected and
reviewed for MRI findings associated with the type of carpal bossing, BME,
insertion site, tenosynovitis/tendinosis of ECRB tendon, and insertion of ECRB
tendon. Sixty-eight participants displayed clinical data on wrist pain.
The 21 per cent of
participants found with fused carpal bossing, 35% with the partial coalition,
and 44% with os styloideum. Sixty-four per cent of patients exhibited regional
BME, 50% of unstable and 78% of stable bosses showed BME. In 20% of the cases
ECRB tendon inserted on carpal boss, in 35% it was inserted on the 3rd
metacarpal and in 45% on both the sites. BME was found at the corresponding
insertion sites in 35%, 66% and 71% patients. Dorsal wrist pain correlated with
BME as indicated by the presence of BME in carpal boss 75% of the participants.
MRI findings suggested the presence of bone marrow oedema.
Skeletal Radiology
MRI of a painful carpal boss: variations at the extensor carpi radialis brevis insertion and imaging findings in regional traumatic and overuse injuries.
Mika T. Nevalainen et al.
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