Orthopedics - Oleksa A.P. 2006

Osteochondropathies
Osteochondropathies of other carpal bones

Osteochondropathy of the capitate bone was first described by Jönsson, of the triquetrum by Zimmer, and of the pisiform by Schmir.

A common clinical manifestation of osteochondropathy in these bones is the onset of pain during physical strain, localized to their respective projections on the wrist. Examination reveals local Swelling and a slight restriction of wrist mobility, as movement intensifies the pain. The pain is particularly pronounced in pisiform osteochondropathy during forceful wrist hyperextension. Palpation allows for a precise localization of pain and helps preliminarily identify which carpal bone is affected. Pisiform osteochondropathy must be differentiated from ulnar styloiditis, which commonly occurs in manual laborers.

The Diagnosis is confirmed radiographically in two projections, with the pisiform bone projected onto the film using a specialized wrist positioning. Radiographs reveal a hazy Bone Structure with tissue Condensation in the affected bone compared to the adjacent Carpal Bones.

The course of the disease is protracted and may last from 4 to 6 months.

Treatment involves resting the radiocarpal joint by immobilizing the hand and forearm with a plaster splint. Patients are advised to avoid any strain on the affected hand and are prescribed local physical therapy and balneotherapy. As a rule, this leads to a complete recovery.