What is the carpometacarpal bump?

Carpometacarpal bump is the formation of a bony mass at the top of the wrist due to trauma, strain, or a congenital condition. In some patients, it can be benign and requires no action unless it grows or starts to cause problems. Other patients need treatment to treat pain, soreness, or limited joint mobility. Conservative treatment options are successful in many cases, while surgery may be an option if the patient does not respond to other treatments.

Some patients are born with a carpometacarpal bump, while others develop signs of the disease in middle age. A swelling may appear in the wrist, right where the metacarpal bones articulate. This should feel firm to the touch and may be hot due to swelling. The condition is sometimes mistaken for a ganglion cyst, so it is important to receive a thorough evaluation to determine the cause of the swelling in the upper wrist to ensure that the patient has the correct diagnosis.

A history of trauma can be a potential indicator, as can repetitive stress. Chronic inflammation around the joint can lead to the formation of a bone spur that grows over time. Basic treatment for carpometacarpal bulge may include anti-inflammatory medications to reduce swelling and stop growth. Splinting and proper support can also help, especially if repetitive strain is the culprit. Patients who continue to experience pain and stiffness with these measures can discuss more aggressive options.

In surgery, a care provider can remove the spur and smooth the surrounding bone to discourage recurrence of the condition. Sometimes a ganglion cyst forms along with the carpometacarpal bump, in which case it too must be removed. During healing, the patient may wear braces to support the joint and promote recovery. These can be removed once the doctor says it's safe. Periodic checkups may be required to determine if the bone spur is growing back, which can be a cause for concern in some cases.

People with a history of carpometacarpal bulge may pay close attention to the affected wrist for signs of recurrence as early as possible. Failed surgeries can occur if the doctor does not remove all of the growth or does not shave enough of the surrounding bone. Medications may also fail to suppress the return of the spur, especially if the patient stops taking them or does not take them regularly. Imaging studies can be used to track the carpometacarpal bulge over time to allow doctors to identify changes that might be of concern.

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