A small bursa at the second carpometacarpal (CMC) joint between the trapezoid and the base of the index finger metacarpal, reducing friction during the limited gliding movement at this very tight joint. The second CMC joint is the most rigid and important for grip stability.
Second CMC joint arthritis is less common than first CMC (basal thumb) arthritis but occurs in manual workers and after metacarpal base fractures. Boss (carpal boss) — a dorsal bony prominence at the second or third CMC joint — may have an associated dorsal bursa producing a firm dorsal wrist mass. Second CMC joint injection is indicated for localised arthritis confirmed by targeted provocative testing.
Bony osteophyte at the second or third CMC joint with overlying dorsal bursa producing a firm dorsal hand prominence mimicking a ganglion, managed by distinguishing it from ganglion by its hard consistency and bony base on imaging.
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