Scaphoid osteochondroma causing FCR rupture: An unusual presentation

Abstract

Background: Osteochondroma, the most common benign bone tumor, typically occurs in long bones but rarely in the carpus. When found in the carpus it poses diagnostic challenges, warranting differential diagnosis to distinguish it from other conditions like intercarpal joint degeneration, ligament lesions, nerve compression, or traumatic injuries. Case report: We present case of a 55-year-old male patient with 6 months of right wrist pain. The patient had no relevant history of trauma or prodromal symptoms. Hand examinations revealed a tenderness to palpation in the region of the scaphoid tubercle and scapho-trapezoidal joint. Sensory examination was normal. Surgery was performed to repair the torn FCR tendon and excise the lesion simultaneously. Histology revealed benign neoplasm composed of trabeculae of mature bone covered with an outer sheath of hyaline cartilage. Histomorphology was suggestive of osteochondroma. Post-operatively there was immediate pain relief. No recurrence was noted on follow-up visits. Conclusion: This case report contributes to the expanding body of knowledge on the clinical presentation, diagnosis, and management of scaphoid osteochondromas, highlighting the need for a nuanced approach to wrist pain, even in the absence of trauma or prodromal symptoms. Level of evidence: Level IV.

Keywords

• Osteochondroma
• Scaphoid
• Flexor carpi radialis
• Wrist pain