Bony protuberance between the capitate and the 2nd or 3rd metacarpal bases can cause palpable fixed prominence dorsal to the wrist. These findings are in keeping with a carpal boss. Differential diagnosis would include carpometacarpal joint osteoarthritis. Carpal boss may result in degenerative changes at the pseudoarticulation, ganglion formation, adventitial bursitis or irritation of the extensor tendons.