- See:
-
Blood Supply to the Wrist
- Discussion:
- located in anterolateral portion of triquetrium (may be a source of DJD and ulnar wrist pain);
- pisiform forms medial border of
tunnel of Guyon (transporting
ulnar nerve and artery);
- tendinous and ligamentous attachements;
-
FCU tendon: pisiform bone is located w/ in FCU tendon;
-
abductor digiti quinti muscle;
- pisometacarpal ligament;
- pisohamate ligament;
- extensor retinaculum;
- flexor retinaculum (
transverse carpal ligament)
- Radiographs:
-
15 reversed oblique view:
- pisotriquetral joint is best seen with 30 deg of wrist supination or utilizing the
carpal tunnel view;
- calcific deposits, which occassionally form at site of insertion of tendon, can cause severe pain;
- Treatment of Frx:
- pts that sustain frx of pisiform most often go on to heal w/o posttraumatic osteoarthritis;
- frequently these pts have ulnar neuropathies, esp w/ wrist frxs or subluxation or dislocation of the pisiform;
- cause of pain about pisiform is chronic calcific tendinitis of
FCU;
- excision of pisiform w/ pain localized to pisotriquetral joint provides almost complete pain relief, w/ minimal
reduction of grip strength or motion;
Pisiform Kinematics in vivo.
RM Moojen MD et al.
JHS. 2001. Vol 26-A. p 901-907.
