The flexor carpi ulnaris (FCU) tendon inserts on the pisiform bone (the sesamoid within the tendon), with secondary extensions to the hamate (via the pisohamate ligament) and the fifth metacarpal base (via the pisometacarpal ligament). This dual pisiform-beyond insertion makes the FCU a powerful wrist flexor and ulnar deviator. The tendon runs along the medial forearm and wrist anterior to the ulna and can be seen and felt during resisted wrist flexion with ulnar deviation.
FCU calcific tendinopathy (calcium hydroxyapatite deposition) produces acute-onset severe medial wrist pain mimicking gout or fracture, with characteristic calcification adjacent to the pisiform on radiograph. Ultrasound-guided barbotage (aspiration and washout of the calcium deposits) provides rapid relief. FCU tendinopathy at the pisiform produces chronic medial wrist pain reproduced by resisted wrist flexion and ulnar deviation. The FCU tendon is harvested for wrist and finger tendon reconstruction given its expendability — wrist flexion can be maintained by flexor carpi radialis and palmaris longus.
Calcium hydroxyapatite deposition in the FCU tendon adjacent to the pisiform produces acute severe medial wrist pain with a calcific density adjacent to the pisiform on plain radiograph; ultrasound-guided barbotage using a 21-gauge needle to aspirate and lavage the calcium deposits provides rapid symptomatic relief within 48 hours in most cases.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
