title: The pisotriquetral joint: osteoarthritis and enthesopathy.
abstract: Pisotriquetral (PT) osteoarthritis (OA) and enthesopathy of the flexor carpi ulnaris (FCU) are pathologies of the hypothenar eminence which both often remain undiagnosed, but can cause ulnar wrist pain. This study determined the prevalence of these pathologies in an older donor population. Twenty wrists were obtained from 10 cadavers with an age ranging from 65 to 94 years. Radiographs were taken of all wrists with the hand in pisotriquetral view and were assessed for osteoarthritic changes of the PT joint and signs of enthesopathy of the FCU. Ten wrists were grossly dissected and the other ten wrists were sagitally sectioned at a thickness of 10 μm. The wrists were analyzed for type and grade of osteoarthritis and signs of enthesopathy. On radiology, 2 out of 20 wrists showed no signs of osteoarthritis, 5 wrists showed severe changes. One wrist showed signs of enthesopathy. On macroscopy, 9 out of 10 wrists showed osteoartritic changes; 5 of these were severely osteoarthritic. On microscopy, all wrists showed some degree of osteoarthritis of which five showed severe changes. Signs of enthesopathy were seen in seven wrists. Pisotriquetral osteoarthritis has a high prevalence in the older donor population and may therefore be a cause of ulnar sided wrist pain. It should therefore always be considered in the differential diagnosis of ulnar sided wrist pain. By performing clinical examination with these pathologies in mind, diagnosis could be a lot faster. Furthermore, based on our results, radiographs seem to be not accurate in diagnosing osteoarthritis of the PT joint and enthesopathy of the FCU.
authors.affiliation: Department of Anatomy, UMC Utrecht, Utrecht, The Netherlands ; Lage Rijndijk 20 E, 2315 JV Leiden, The Netherlands.
authors.forename: K E
authors.initials: KE
authors.lastname: Kofman
authors.affiliation: Department of Plastic and Reconstructive Surgery, UMC Utrecht, Utrecht, The Netherlands.
authors.forename: A H
authors.initials: AH
authors.lastname: Schuurman
authors.affiliation: Department of Anatomy, UMC Utrecht, Utrecht, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Mulder
authors.affiliation: Department of Anatomy, UMC Utrecht, Utrecht, The Netherlands.
authors.forename: S A M W
authors.initials: SA
authors.lastname: Verlinde
authors.affiliation: TNO, Metabolic Health Research, Leiden, The Netherlands.
authors.forename: L M
authors.initials: LM
authors.lastname: Gierman
authors.affiliation: Department of Pathology, UMC Utrecht, Utrecht, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: van Diest
authors.affiliation: Department of Anatomy, UMC Utrecht, Utrecht, The Netherlands.
authors.forename: R L A W
authors.initials: RL
authors.lastname: Bleys
keywords: Enthesopathy; Flexor carpi ulnaris; Osteoarthritis; Pisiform; Pisotriquetral joint; Triquetrum; Ulnar-sided wrist pain