Presentation
FOOSH 3 weeks ago. Pain in the lateral wrist near distal ulnar bone.
Patient Data
There is evidence of a recent fracture of the pisiform carpal bone. There is a linear oblique fracture line evident. The fracture extends form medial to proximal cortex. There is no significant distraction or angulation. Adjacent soft tissue swelling is present.
Zoomed frontal and lateral projections.
Case Discussion
In this case, the fracture line is evident in the frontal and lateral projection, with cortical and trabeculae disruption.
Pisiform fractures account for less than 1% of carpal bone fractures. They are a rare injury and often missed. Mechanism of injury usually results from direct impact on a hard surface or a FOOSH, as in this case.
CT study is recommended to further evaluate acute or chronic bony injury, delineate fracture pattern and determine treatment plan.
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