Case report: Osteoma of a sesamoid bone as a rare cause of hand pain
Sesamoid bones are usually ovoid shaped bones found within tendons on palmar and plantar articular surfaces, where tendons run in close proximity to joints. They are variable in size, shape and location, but in the hand they are most commonly found at the metacarpophalangeal joint of the thumb, interphalangeal joint of the thumb and the metacarpophalangeal joints of the index and little fingers. A 72-yearold gentleman presented with a painful lump in his right hand over the palmar aspect of his 5th metacarpophalangeal joint. The pain had become so severe that it impaired his grip strength causing functional difficulties. X-ray imaging demonstrated the presence of a sesamoid bone, which was excised under local anaesthetic and sent for histology. Macroscopically, the excised lump resembled a mixture of fatty and nodular bony tissue. Microscopically, it showed dense lamellar bone surrounded by collagenized fibrovascular stroma, with morphologic features suggestive of an ivory osteoma. The patient ultimately recovered well from surgery, and to date has had no further symptoms or functional impairment. Osteoma of a sesamoid bone is a rare cause of hand pain. In this case excision proved to be successful in relieving the pain and improving function.
- Trauma and Orthopaedics