The carpal boss (carpe bossu) is a bony protuberance at the carpometacarpal joints of the index and middle fingers. It is most commonly caused by an osteophyte at the base of the metacarpal bones originating from the carpometacarpal joint, or less commonly, by a supernumerary bone (e.g, an os styloideum), as seen in the image above. A carpal boss may be accompanied by a small ganglion cyst.
References
Conway WF, Destouet JM, Gilula LA, Bellinghausen HW, Weeks PM. The carpal boss: an overview of radiographic evaluation. Radiology. 1985 Jul;156(1):29-31.
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