Presentation
Fall. Painful wrist.
Patient Data
Age: 22
Gender: Male
From the case:
Os triangulare
{"study":{"id":25314,"case_slug":"os-triangulare","modality":"X-ray","series":[{"id":4749993,"content_type":"image/jpeg","frames":[{"id":4749993,"width":1240,"height":1754,"current":true}],"annotations":[],"encodings":{"original_dicom":null,"video":null,"thumbnailed_files":[{"tiny":"a2dc0333555b467d5d07e18d4a1994_tiny.jpg","jumbo":"a2dc0333555b467d5d07e18d4a1994_jumbo.jpg","small":"a2dc0333555b467d5d07e18d4a1994_small.jpg","thumb":"a2dc0333555b467d5d07e18d4a1994_thumb.jpg","medium":"a2dc0333555b467d5d07e18d4a1994_medium.jpg","gallery":"a2dc0333555b467d5d07e18d4a1994_gallery.jpg","big_gallery":"a2dc0333555b467d5d07e18d4a1994_big_gallery.jpg","original":"a2dc0333555b467d5d07e18d4a1994.jpg"}]},"perspective":"Frontal","specifics":null},{"id":4750001,"content_type":"image/jpeg","frames":[{"id":4750001,"width":1240,"height":1754,"current":true}],"annotations":[],"encodings":{"original_dicom":null,"video":null,"thumbnailed_files":[{"tiny":"b3d4895ef6d8df0c1682a12c18da64_tiny.jpg","jumbo":"b3d4895ef6d8df0c1682a12c18da64_jumbo.jpg","small":"b3d4895ef6d8df0c1682a12c18da64_small.jpg","thumb":"b3d4895ef6d8df0c1682a12c18da64_thumb.jpg","medium":"b3d4895ef6d8df0c1682a12c18da64_medium.jpg","gallery":"b3d4895ef6d8df0c1682a12c18da64_gallery.jpg","big_gallery":"b3d4895ef6d8df0c1682a12c18da64_big_gallery.jpg","original":"b3d4895ef6d8df0c1682a12c18da64.jpg"}]},"perspective":"Oblique","specifics":null}],"caption":{"us":null,"gb":null},"findings":{"us":"","gb":""},"contributor_login":"henryknipe","case_id":25054,"case_key_image_id":null,"case_featured_at":null},"current_user":null,"access":{"can_edit":false,"can_download":true,"can_feature":false,"can_pin":true}}
Well corticated bony fragment distal to the ulna fovea, adjacent to the ulna styloid. Most consistent with an accessory ossicle - os triangulare.
From the case:
Os triangulare
{"study":{"id":25320,"case_slug":"os-triangulare","modality":"Annotated image","series":[{"id":4750497,"content_type":"image/jpeg","frames":[{"id":4750497,"width":445,"height":630,"current":true}],"annotations":[],"encodings":{"original_dicom":null,"video":null,"thumbnailed_files":[{"tiny":"024cbe0633ec0cf38000f6c28d70cd_tiny.jpg","jumbo":"024cbe0633ec0cf38000f6c28d70cd_jumbo.jpg","small":"024cbe0633ec0cf38000f6c28d70cd_small.jpg","thumb":"024cbe0633ec0cf38000f6c28d70cd_thumb.jpg","medium":"024cbe0633ec0cf38000f6c28d70cd_medium.jpg","gallery":"024cbe0633ec0cf38000f6c28d70cd_gallery.jpg","big_gallery":"024cbe0633ec0cf38000f6c28d70cd_big_gallery.jpg","original":"024cbe0633ec0cf38000f6c28d70cd.jpg"}]},"perspective":null,"specifics":null}],"caption":{"us":null,"gb":null},"findings":{"us":"","gb":""},"contributor_login":"henryknipe","case_id":25054,"case_key_image_id":null,"case_featured_at":null},"current_user":null,"access":{"can_edit":false,"can_download":true,"can_feature":false,"can_pin":true}}
Annotated image thanks to Dr Ian Bickle.
Case Discussion
Accessory ossicles are an important differential diagnosis to fractures, especially in the wrist where more than 20 have been documented.