Isolated pisiform bone fracture - chronic (MRI)

Case contributed by Bahman Rasuli
Diagnosis probable

Presentation

Pain in the wrist several months following a wrist trauma.

Patient Data

Age: 65
Gender: Male

Non displaced transverse fracture line within the pisiform bone at the inferior and proximal aspects is present.

Bone marrow edematous changes and overlying soft tissue swelling is not seen due to chronic fracture.

Case Discussion

The pisiform is a small round carpal bone located in the volar and ulnar aspect of the wrist. The flexor carpi ulnaris tendon and the transverse carpal ligament insert into the pisiform bone. Pisiform bone fractures are often due to direct trauma to the hypothenar area or avulsion fracture when the flexor carpi ulnaris resists forcible hyperextension of the wrist.

In this case, the old missed fracture of the pisiform bone occurred because of direct trauma several months ago.

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