The scaphoid tubercle is a rounded projection on the palmar and radial aspect of the distal scaphoid pole, palpable at the base of the thenar eminence just distal to the radial styloid. The flexor carpi radialis tendon passes in a groove adjacent to it, the abductor pollicis brevis and opponens pollicis attach to the flexor retinaculum overlying it, and the radial artery crosses near it in the anatomical snuffbox.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Ossified as part of the scaphoid, whose single centre appears at about 4-6 years; occasionally a separate tubercle centre is present. |
The scaphoid tubercle is the palpation target in Watson scaphoid shift test for scapholunate instability, where dorsal pressure on the tubercle during radial-to-ulnar deviation provokes the scaphoid to sublux if the scapholunate ligament is deficient. Tenderness of the scaphoid tubercle on palmar pressure, combined with anatomical snuffbox tenderness, is a sensitive but not specific sign for scaphoid fracture. STT arthrosis produces pain directly at the tubercle that is reproduced by axial loading.
Turn the hand palm up and extend the wrist slightly. At the distal wrist crease at the base of the thenar eminence, follow the flexor carpi radialis tendon down to a firm bony bump just to its outer side; this is the scaphoid tubercle. It becomes more prominent when the wrist is bent toward the thumb.
Tenderness directly over the scaphoid tubercle on the palmar radial wrist, combined with anatomical snuffbox tenderness, provides high sensitivity for scaphoid fracture after a fall on the outstretched hand, requiring MRI when plain radiographs are negative.
Dorsal pressure on the scaphoid tubercle during wrist ulnar deviation prevents normal scaphoid flexion; in scapholunate instability the scaphoid subluxes dorsally producing a painful clunk, with a false positive rate requiring correlation with other clinical and imaging findings.
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