Accessory ossicles of the wrist

Last revised by Evangeline Collins on 16 Aug 2024

Citation, DOI, disclosures and article data

Citation:

Knipe H, Collins E, Riahi P, et al. Accessory ossicles of the wrist. Reference article, Radiopaedia.org (Accessed on 20 Mar 2025) https://doi.org/10.53347/rID-23575

DOI:

https://doi.org/10.53347/rID-23575

Permalink:

https://radiopaedia.org/articles/23575?embed_domain=hackmd.io%252525252525252F%2525252525252540yIPUAFeCSL2JsU8smR5nJQ%252525252525252Fbnjhjgjghjghjgh

rID:

23575

Article created:

24 Jun 2013, Henry Knipe ◉

Disclosures:

At the time the article was created Henry Knipe had no recorded disclosures.

View Henry Knipe's current disclosures

Last revised:

16 Aug 2024, Evangeline Collins

Disclosures:

At the time the article was last revised Evangeline Collins had no financial relationships to ineligible companies to disclose.

View Evangeline Collins's current disclosures

Revisions:

16 times, by 11 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Sections:

Anatomy

Tags:

wrist, normal, bone, variant

Synonyms:

Accessory ossicle of the wrist
Accessory carpal bones
Accessory carpal ossicles
Supernumerary carpal bones
Supernumerary carpal ossicles
Supernumerary 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:

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: