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Accessory ossicles of the wrist

Changed by Yuranga Weerakkody, 10 May 2017

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Accessory ossicles of the wrist are commonly seen on plain radiographs of the wrist and associated cross-sectional imaging. Over 20 were originally described ², although the more common include ¹:

lunula: between TFCC and triquetrum
os styloideum (carpal boss): on dorsal surface of 2^nd or 3^rd metacarpal bases
os triangulare: just distal to ulnar fovea
trapezium secondarium: medial to tubercle of trapezium on volar surface
os epilunate: dorsal to lunate
os hamuli proprium: at tip of hamate hook

A handy mnemonic is LOTTEO.

The full list ² can be broadly split into three groups: those around the carpometacarpal joints, those around the scaphoid and those around the lunate.

The distal row, from ulnar margin to radial margin are:

The ossicles that surround the scaphoid (starting at the radioscaphoid joint and working anti-clockwise):

paranavicular
os radiostyloideum (persistent radial styloid)
os radiale externum
epitrapezium
os centrale carpi

The ossicles that surround the lunate (starting at the scapholunate joint and working anti-clockwise):

os hypolunatum
os epilunatum
epipyramis
accessory bone between lunate and triquetrum
lunula
os triangulare
persistent ulnar styloid
small bony element at the radioulnar joint

~~-<li>os vesalianum</li>~~
~~-<li>os ulnare externum</li>~~
~~-<li>os hamuli proprium</li>~~
~~-<li>secondary capitate</li>~~
~~-<li>gruber ossicle</li>~~
~~-<li>os styloideum</li>~~
~~-<li>secondary trapezoid</li>~~
~~-<li>trapezium secondarium</li>~~
+<li><a title="Os vesalianum" href="/articles/os-vesalianum">os vesalianum</a></li>
+<li>
+<a title="os ulnare externum" href="/articles/os-ulnare-externum">os ulnare </a><a title="os ulnare externum" href="/articles/os-ulnare-externum">externum</a>
+</li>
+<li>
+<a title="Os hamuli proprium" href="/articles/os-hamuli-proprium">os hamuli </a><a title="Os hamuli proprium" href="/articles/os-hamuli-proprium">proprium</a>
+</li>
+<li><a title="secondary capitate" href="/articles/secondary-capitate">secondary capitate</a></li>
+<li>
+<a title="gruber ossicle" href="/articles/gruber-ossicle">gruber</a><a title="gruber ossicle" href="/articles/gruber-ossicle"> ossicle</a>
+</li>
+<li>
+<a title="os styloideum" href="/articles/os-styloideum">os </a><a title="os styloideum" href="/articles/os-styloideum">styloideum</a>
+</li>
+<li><a title="secondary trapezoid" href="/articles/secondary-trapezoid">secondary trapezoid</a></li>
+<li>
+<a title="trapezium secondarium" href="/articles/trapezium-secondarium">trapezium </a><a title="trapezium secondarium" href="/articles/trapezium-secondarium">secondarium</a>
+</li>
~~-<li>os centrale carpi</li>~~
+<li><a title="os centrale carpi" href="/articles/os-centrale-carpi">os centrale carpi</a></li>
~~-<li>os hypolunatum</li>~~
~~-<li>os epilunatum</li>~~
~~-<li>epipyramis</li>~~
+<li>
+<a title="os hypolunatum" href="/articles/os-hypolunatum">os </a><a title="os hypolunatum" href="/articles/os-hypolunatum">hypolunatum</a>
+</li>
+<li>
+<a title="os epilunatum" href="/articles/os-epilunatum">os </a><a title="os epilunatum" href="/articles/os-epilunatum">epilunatum</a>
+</li>
+<li><a title="epipyramis" href="/articles/epipyramis">epipyramis</a></li>
~~-<li>lunula</li>~~
~~-<li>os triangulare</li>~~
+<li><a title="Lunula" href="/articles/lunula">lunula</a></li>
+<li>
+<a title="Os triangulare" href="/articles/ostriangulare">os </a><a title="Os triangulare" href="/articles/ostriangulare">triangulare</a>
+</li>

Images Changes:

Image 2 Annotated image ( update )

Caption was changed:

~~All~~Fig 1: all the ossicles

Image 3 Annotated image (Distal row of ossicles) ( update )

Caption was changed:

~~Ossicles~~Fig 2: ossicles around the carpometacarpal joint

Image 4 Annotated image (The ossicles around the scaphoid) ( update )

Caption was changed:

~~Ossicles~~Fig 3: ossicles around the scaphoid

Image 5 Annotated image (The ossicles around the lunate) ( update )

Caption was added:

Fig 4: ossicles of the wrist and hand

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