The pisotriquetral joint is a small plane synovial joint between the pisiform and the dorsal triquetrum. The pisiform is a sesamoid bone in the FCU tendon that amplifies FCU wrist flexion-ulnar deviation leverage. Pisotriquetral arthritis produces ulnar-sided wrist pain reproduced by direct pisiform palpation and shear of the pisiform on the triquetrum.
Pisotriquetral arthritis produces the classic ulnar-sided wrist pain reproduced by compressing and shearing the pisiform against the triquetrum (pisotriquetral grind test). Pisiform excision reliably relieves symptoms of pisotriquetral arthritis with minimal functional consequence.
Degenerative joint disease producing ulnar wrist pain at the pisiform managed with injection and pisiform excision for refractory cases.
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