RESUMEN
Carpal boss is an uncommon condition whose incidence is underestimated and that is frequently confused with other causes of development of tumor-like lesions on the dorsum of the wrist. From the clinical point of view, the main obstacle to its recognition is the nonspecificity of symptoms, frequently attributed to dorsal ganglion cysts, since both conditions share a similar location on the dorsum of the wrist. The assessment by ultrasonography allows for a correct diagnosis and appropriate management, with better chances of resolution of the clinical complaint and lower probability of iatrogenic worsening of the lesion. The present review is aimed at describing the different sonographic findings of carpal boss.
A bossa carpal é uma enfermidade incomum, porém de incidência subestimada, frequentemente confundida com outras causas de tumoração no carpo dorsal. Do ponto de vista clínico, o principal obstáculo ao seu reconhecimento reside na inespecificidade dos sintomas, frequentemente atribuídos a cistos dorsais, já que ambos compartilham localização muito semelhante no carpo. A avaliação por ultrassonografia permite diagnóstico correto e manejo específico, que resulta em melhores chances de resolução da queixa clínica e menor probabilidade de piora iatrogênica da lesão. O objetivo deste artigo é revisar as diferentes apresentações ultrassonográficas da bossa carpal.
RESUMEN
PURPOSE: Carpal boss of the hand is a rare lesion. This study was conducted to recognize the clinical patterns of this disease entity and to evaluate the diagnosing modalities, differencial diagnosis, and results after operative treatment. MATERIALS AND METHODS: We report upon 7 operative cases of carpal boss of the hand. There were 5 females and 2 males with an aver-age age of 35.4. The mean follow up period for patients in this study was 15 months. The dominant hand was affected in 4 cases and the small ganglion was associated with the carpal boss in 4 cases. RESULTS: The average duration of conservative treatment before surgical treatment was 8.3 months. All of the patients had taken NSAIDs prior to surgery and 4 patients had received a corticosteroid injection at least once. All of the patient had surgical treatment and complete symptomatic relief was achieved in 6 cases. One patient had no symptomatic relief. CONCLUSION: We operated upon patients who did not respond to conservative treatment or in whom the carpal boss associated with a ganglion, 5 of 7 cases showed a satisfactory result. In view of these results, we recommended that operative treatment should be con-sidered in such cases.