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Accessory ossicles of the wrist

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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><a title="os vesalianum carpi" href="/articles/os-vesalianum-carpi">os vesalianum carpi</a></li>~~
+<li><a href="/articles/os-vesalianum-carpi">os vesalianum carpi</a></li>

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Accessory ossicles of the wrist

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