Missed our latest free live-stream? Catch up now on our Procedure Tips (Chris Nicholas) and Right Lower Quadrant Pain (Matt Morgan)

Accessory ossicles of the wrist

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:

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):

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

Anatomy: Upper limb

Anatomy: Upper limb

Article information

rID: 23575
Section: Anatomy
Synonyms or Alternate Spellings:
  • Accessory ossicle of the wrist

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1: all the ossicles
    Drag here to reorder.
  • Figure 2: ossicles around the carpometacarpal joint
    Drag here to reorder.
  • Figure 3: ossicles around the scaphoid
    Drag here to reorder.
  • Figure 4: ossicles of the wrist and hand
    Drag here to reorder.
  • Case 1: os hypolunatum
    Drag here to reorder.
  • Case 2: accessory ossicle of wrist (paranavicular)
    Drag here to reorder.
  • Case 3: epipyramis
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.