Carl

Pisotriquetral arthritis problems

Hi, I saw a specialist just over a year ago who diagnosed me with Pisotriquetral Arthritis, Pisiform (bone) pain. He did not give me an X Ray or MRI. He gave me two cortisone injections which helped for about 6 months. The pain in the pisiform bone is really quite severe now and I can not put any weight on it. The pain is there 24 hours a day and is no better or worse at any point. So can it really be arthritis? Can you help please ?

16 January 2017

Dear Carl,

The pisiform bone is one of the eight carpal (wrist) bones. It is a small pea-shaped sesamoid bone located where the ulna (one of the bones in the forearm) joins the wrist (on the little finger side). Pain and tenderness on the palmar and ulnar aspects of the wrist in the area of the pisiform bone is fairly common. Chronic pain in the pisiform area may be caused by tendonitis of the flexor carpi ulnaris, bony fractures or osteoarthritis of the pisotriquetral joint.

Osteoarthritis of the pisotriquetral joint is most often caused by acute and chronic trauma and instability. The symptoms of osteoarthritis of the pisotriquetral joint are pain over the pisiform, with pressure and grinding of the joint. There may be ulnar nerve symptoms such as numbness and tingling in the little finger and along the outside of the ring finger.

Conservative treatment of pisotriquetral arthritis consists of local injections of steroid into the pisotriquetral joint along with nonsteroidal anti-inflammatory drugs (NSAIDs) and a protective splint. When conservative therapy fails, consideration may be given to pisiform excision (Surgery). May I suggest you make an appointment with your G.P or orthopaedic specialist to discuss further diagnostic investigations and management options. We hope this has been of some help to you.

Answered by the Health at Hand nurses  

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