Semin Musculoskelet Radiol 2019; 23(05): 511-522
DOI: 10.1055/s-0039-1693974
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hand and Wrist: A Kaleidoscopic View of Accessory Ossicles, Variants, Coalitions, and Others

1  Department of Radiology and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
2  Department of Radiology, AZ Sint-Maarten, Duffel-Mechelen, Belgium
,
Frederik Bosmans
2  Department of Radiology, AZ Sint-Maarten, Duffel-Mechelen, Belgium
3  Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium
,
Karl Waked
4  Department of Plastic Surgery, University Hospital Brussels, Brussels, Belgium
,
Filip M. Vanhoenacker
1  Department of Radiology and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
2  Department of Radiology, AZ Sint-Maarten, Duffel-Mechelen, Belgium
3  Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium
› Author Affiliations
Further Information

Publication History

Publication Date:
25 September 2019 (online)

Abstract

Accessory bones, variants, and coalitions are not uncommon at the hand-wrist region. They are often overlooked because they are usually asymptomatic and found incidentally on imaging. However, they may sometimes present as a (painful) swelling or mimic a (sequel of a) fracture. Other symptoms may be attributed to impingement and exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of their existence are the clues to a correct identification. Plain radiography and magnetic resonance imaging (MRI) play a pivotal role in the correct diagnosis. In general, signal intensity on MRI is similar to the normal bony structures. However, concomitant bone marrow edema may indicate the presence of impingement. Therefore, MRI sequences with fat suppression should be included in case of symptomatic findings. This article provides a kaleidoscopic overview of some of the prevalent bony anomalies of the hand-wrist region and their potential pathogenic nature.