Sesamoid disorders of the hand

Os Subepicondylare Mediale in the Elbow: A Radiographic Case Report of a Sesamoid Bone

Sesamoid and accessory bones are small, oval-shaped structures that develop within tendons that pass over bony prominences. Although rare, accessory bones in the elbow region hold clinical significance because they can cause diagnostic uncertainty. We present the case of a 47-year-old previously healthy female patient who presented with left elbow pain and was discovered to have a sesamoid bone distal to the medial epicondyle of the humerus. On examination, the patient's left elbow was tender, but her range of motion was in normal range. Plain radiographs identified a small, oval-shaped bony fragment; further radiographic investigations were conducted. Computed tomography and ultrasound were performed to rule out diagnostic uncertainties. A diagnosis of os subepicondylare mediale, a rare sesamoid bone, was established through a thorough investigation of the well-circumscribed structure in accordance with the most current literature.

Prevalence of metacarpophalangeal sesamoid bones of the hand in Turkish population

OBJECTIVES

This study aims to investigate the prevalence and location of the metacarpophalangeal (MCP) sesamoid bones using computed tomography (CT) images.

PATIENTS AND METHODS

A total of 767 hands of 735 patients (503 males, 232 females; mean age: 36.9±17.0 years; range, 18 to 105 years) obtained from picture archiving and communication system were retrospectively analyzed between January 2016 and December 2019. The sesamoid bones of MCP joints I, II, III, IV, and V were recorded. Data including age, sex, side, number, pathologies, and location of the sesamoid bones were recorded.

RESULTS

The prevalence of sesamoid bones was found to be 100%, 37.61%, 1.17%, 0.5%, and 80% in MCP I, II, III, IV, and V, respectively. There was no significant correlation between the sex of the patient and presence of sesamoid bone at MCP II or MCP V (p>0.970 and p=0.176, respectively). The presence of sesamoid bone at MCP II was statistically significantly correlated with the presence of sesamoid bone at MCP V (p<0.001). There was no statistically significant difference in the side and sesamoid prevalence in the remaining 703 patients (p>0.05).

CONCLUSION

The prevalence of MCP V sesamoid bone is higher than previous studies from our country. The CT of hand can be used to determine sesamoid fractures and degenerative conditions of sesamoids.

Sesamoid bones of the hand: A multicenter study

Objectives

This study aims to document a detailed investigation on the sesamoid bones (SBs) of Turkish subjects from different parts of Turkey in a multi-center study, in both hands, according to gender, frequency and divisions of the bones’ coexistence and bilaterality by radiography.

Patients and methods

This retrospective and three-centered study was performed between June 2010 and April 2012. Sesamoid bones were examined by anteroposterior and oblique X-rays of 1,444 hands of 772 subjects (367 males, 405 females; mean age 42.7 years; range, 18 to 87 years). All X-rays were evaluated by at least two independent observers. In controversial circumstances, at least three observers together gave the final decision by consensus.

Results

Metacarpophalengeal (MCP) joint of the thumb (MCP 1) had sesamoid in all subjects (100%) and it was seen bilaterally. The prevalence of the SB was 42.8% in the second MCP joint (MCP 2) in 772 subjects and 36.6% in 1,444 hands, 1.6% in the third MCP joint (MCP 3) for the subjects and 1.1% for the hands, 0.1% in the fourth MCP joint (MCP 4) for the subjects and 0.1% for the hands, and 72.5% in the fifth MCP joint (MCP 5) for the subjects and 62.5% for the hands. The prevalence of SB in the first interphalangeal joint (IP 1) was 21.8% and SB was detected in 18.6% of the hands. Sesamoid bones of the MCP 2, MCP 5, and IP 1 was recorded more frequently in females. Sesamoid bone of the same joints (MCP 2, MCP 5 and IP 1) was detected more frequently bilaterally than unilateral right side and more frequently unilaterally on right side than unilateral left side.

Conclusion

The distribution of SBs varies according to hand regions, gender, and side. Having knowledge of the locations and the rate of bilaterality of SBs may assist clinicians in both clinical and radiological diagnoses.

Prevalence and distribution of sesamoid bones of the hand in Omani subjects: a radiological study

Sesamoid bones show considerable variations in their occurrence among various ethnicities. This study aims to evaluate the prevalence and distribution patterns of the sesamoid bones of the hands among Omani patients who were referred for radiological investigations. The influence of gender and different age groups on the occurrence of sesamoid bones of the hand was determined using the Chi-square test. Spearman's rank correlation was used to determine the coexistence of sesamoid bones at the metacarpophalangeal joints. A total of 541 hand radiographs were reviewed. A high prevalence of sesamoid bones at the fifth metacarpophalangeal joint and the interphalangeal joint of the thumb was noted with a frequency of 64% and 49.7%, respectively. There were ten different patterns of sesamoid bones detected, the most common of which was the presence of sesamoid bones at the first and fifth metacarpophalangeal joints found in 32.9% of the radiographs. A statistically significant gender difference was observed at the interphalangeal joint of the thumb (p = 0.025) and fifth metacarpophalangeal joint (p = 0.027) with a female dominance. A significant association between the age and prevalence of sesamoid bones was noted at the fifth metacarpophalangeal joint (p = 0.03). The prevalence of the sesamoid bones of the hand in Omani subjects seems to differ from other Middle Eastern populations, particularly at the fifth metacarpophalangeal joint and the interphalangeal joint of the thumb. In the meantime, the baseline data of our study can be helpful while treating the patients complaining of hand discomfort or pain.

Fracture of the Fifth Finger Sesamoid: A Rare Injury

Fracture of the hand sesamoid bones is rare. Fractures are usually missed initially. Mechanism of injury is usually reported as hyperextension and less frequently as direct compression of metacarpophalangeal joint. Fracture of the hand sesamoid bones has been usually reported in the thumb. We report a case of fifth-digit sesamoid fracture, treated conservatively. In 6 months of followup, the patient had a full range of motion without pain.