The most common cause of a wrist lump is a ganglion cyst, a noncancerous and usually harmless condition. However, a bump on the back of the wrist might be something known as a carpal boss instead.
Also known as a carpometacarpal boss (or simply bossing), a carpal boss is a bony, benign overgrowth that can be mistaken for a ganglion cyst. An experienced hand and wrist specialist can tell the difference between these two conditions.
Symptoms of a Carpal Boss
A wrist bump caused by carpal bossing typically feels firm and immoveable, and for many patients, the lump presents no other symptoms. In some cases, however, bossing comes with pain, particularly with upward and downward movement of the wrist. Restricted joint mobility and joint instability can also occur with this condition.
Symptoms of a Ganglion Cyst
A wrist bump caused by a ganglion cyst may feel soft and spongy. Or in some cases, the lump might be firm like a carpal boss. Most often, this condition is painless; however, if the cyst puts pressure on a nerve, then pain, tingling and muscle weakness can occur.
Diagnosing the Cause of a Wrist Lump
Light can pass through many ganglion cysts, which is helpful in determining the cause of a lump. To make an accurate diagnosis, however, imaging studies accompany the light permeability test and a physical examination. An X-ray can reveal a carpal boss or bone condition, while an MRI or ultrasound can show a cyst or other soft tissue disorders.
Treatment Options for a Wrist Lump
Treatment is only needed when a wrist bump becomes painful or limits activity.
For both carpal bossing and ganglion cysts, conservative treatments can be effective. Avoiding activities that create pain, wearing a splint, icing the area and taking nonsteroidal anti-inflammatory medication (NSAIDs) may provide relief. Other nonsurgical options — such as steroid injections for bossing or aspiration for a cyst — may also be considered. When conservative treatments fail, surgery to remove the lump might be recommended.
Other conditions — including fibrosis, neuroma, enchondroma or a malignant tumor — can also cause a wrist lump to develop. For that reason, an experienced hand and wrist specialist should evaluate every bump. Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence is northern Utah’s leading fellowship-trained, board-certified expert in hand and wrist conditions.
With more than 20 years of experience serving the greater Salt Lake City area, Dr. Burrows has the training, knowledge and skill to provide you with an accurate diagnosis and successful treatment plan. Contact our West Valley City office and schedule a consultation to find out if a carpal boss, ganglion cyst or some other condition is the cause of your wrist lump.