Subluxation & dislocation
Diagnosis
Pisotriquetral view
- forearm positioned 30° supinated off the neutral position
- loss of symmetry between the pisiform and triquetrum is required for the diagnosis
- carpal tunnel view may be helpful in further assessment of the joint
Osteoarthritis
Clinical
More common problem
Associated with localized tenderness over the pisotriquetral joint
- usually manipulation of the pisiform over the triquetrum causes intense pain
- local anaesthetic injection into the pisotriquetral joint confirms the diagnosis
X-ray
Often show loss of joint space and osteophyte formation
Management
Rest / NSAID's / HCLA pisotriquetral joint
Pisiform excision from the FCU tendon sheath