Its not good to be too bossy - Carpal bossing: A case report with review of literature

A 27-year-old male boxer presented with pain in the dorsum of the right wrist and difficulty in getting a firm grip on his hand for a 2-month duration. On examination, he had swelling over the dorsal aspect of the right wrist. Physical examination revealed a bony hard mass at the junction of the third metacarpal and capitate bones. The pain persisted despite conservative treatment and the patient was referred to our hospital for further evaluation. Radiographs of the right wrist posteroanterior and lateral views showed an accessory bone projecting from the base of the third metacarpal. The patient was evaluated on a multidetector computed tomography scan, which showed a bony protuberance arising from the dorsal aspect of the base of the third metacarpal showing continuation with the parent bone. No osteophyte/fracture of the bone could be appreciated. On magnetic resonance imaging, marrow edema was noted in the bony protuberance with edema in the overlying soft tissues. The patient underwent third metacarpal boss excision. At present, the patient is asymptomatic and is on regular follow-up.