Pisiform instability can cause nondescript pain over lateral hand eminence, and in some cases present with ulnar nerve damage. It is little recognized.
J Hand Surg Am. 2018 Jan;43(1):54-60.
Management of Pisotriquetral Instability.
Shulman BS et al
- Hypothenar eminence nonspecific pain.
- feelings of clicking or locking, especially during active
- pain with direct pressure like weight lifting
- pisiform ballottement or shuck test. – move pisiform from side to side and see if hurts (do with wrist flexed and relaxed)
Xrays -semisupination view – wrist in 30 degrees supination
- Immobilization- short-arm cast or removable wrist brace
for 4 to 6 weeks
- steroid injection
- above works 1/3 of time
- I would add prolotherapy as a given for instability treatment
- surgery involves removal- Pisiformectomy with 75-93% pain free following
Comment – another condition I will know now if I see.