The pisotriquetral joint is a small plane synovial joint between the pisiform and the palmar surface of the triquetrum. The pisiform is a sesamoid bone in the FCU tendon that improves FCU leverage for wrist flexion and ulnar deviation. The joint cavity often communicates with the radiocarpal joint. Pisotriquetral arthritis produces ulnar-sided wrist pain reproduced by direct pisiform palpation and shear of the pisiform on the triquetrum.
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Pisotriquetral arthritis produces ulnar-sided wrist pain reproduced by compressing and shearing the pisiform against the triquetrum (pisotriquetral grind test). Oblique or carpal tunnel radiographs and CT show joint narrowing, sclerosis and cysts. Corticosteroid injection, often ultrasound guided, gives temporary relief. Pisiform excision reliably relieves refractory symptoms 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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