What is Metacarpal Boss?
Metacarpals are the bones of the hand located between the wrist bones know carpals and the finger bones called phalanges. Metacarpal Boss, often called Carpal Boss, is a common condition that manifests as a firm bump or swelling on the back of the hand usually where the metacarpals articulate with the carpals of the wrist. The term “Boss” comes from the French “Bosse” which means tumor, bump or swelling.
What causes Metacarpal Boss?
Usually Metacarpal Boss is caused by Osteoarthritis or trauma. Over time the cartilage lining the joints thins and wears away. The body naturally responds to this with the formation of new bone leading to the bulky growth or bone spur.
What are the symptoms of Metacarpal Boss?
Metacarpal Boss presents as a firm prominence at the base of the 2nd or 3rd metacarpal. It is often painless and is more of an aesthetic nuisance. However, if a tendon, inflamed bursa, or ganglion cyst is involved then pain may be troublesome.
How is Metacarpal Boss diagnosed?
Your hand specialist will request a detailed history and review of symptoms along with physical examination of the affected hand. Since Metacarpal Boss is often confused with a ganglion cyst, X-rays, ultrasound, or MRI may be used to visualize internal structures and confirm diagnosis.
How is Metacarpal Boss treated?
Activities that exacerbate the pain must be modified or eliminated. Immobilizing the wrist with a splint during specific activities is an excellent way to rest and protect the joint. Analgesics and anti-inflammatory medications like ibuprofen and naproxen are helpful in reducing pain and swelling. If these do not provide significant relief and injectable steroid may be prescribed.
In extreme cases your hand specialist may recommend an operation to remove the Metacarpal Boss. The excision is usually performed on an outpatient basis. Most clients report a good or excellent result with relief from pain and swelling after the procedure.
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