What is the location of subtle cortical irregularity at the volar aspect of the pisiform (proximal interphalangeal joint) bone?

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From the Guidelines

The subtle cortical irregularity at the volar aspect of the pisiform is located on the palm-facing surface of the pisiform bone, which is a small, pea-shaped sesamoid bone in the wrist. This irregularity refers to a slight disruption or unevenness in the outer layer (cortex) of the bone on the side that faces the palm. The pisiform bone is positioned on the ulnar (pinky finger) side of the wrist, where it articulates with the triquetrum bone and serves as an attachment point for several ligaments and the flexor carpi ulnaris tendon. Such cortical irregularities may represent normal anatomical variation, a response to repetitive stress, or occasionally early signs of pathology such as arthritis or prior trauma. This finding is often incidental on imaging studies like X-rays or MRIs and may not be clinically significant unless associated with symptoms such as pain, swelling, or limited range of motion in the wrist, as noted in studies on hand and wrist trauma 1, 2, 3. Key points to consider include:

  • The pisiform bone's location and function in the wrist
  • The potential causes of cortical irregularities, including normal variation, repetitive stress, and pathology
  • The importance of considering symptoms and clinical significance when evaluating this finding
  • The role of imaging studies, such as X-rays and MRIs, in detecting and characterizing cortical irregularities. Given the information provided and the focus on morbidity, mortality, and quality of life, it is essential to approach this finding with a thorough clinical evaluation and consideration of the patient's overall condition, rather than relying solely on imaging findings 1.

From the Research

Location of Subtle Cortical Irregularity

  • The location of subtle cortical irregularity at the volar aspect of the pisiform is not explicitly mentioned in the provided studies 4, 5, 6, 7, 8.

Relevant Information

  • The studies primarily focus on osteoid osteoma, benign bone lesions, and cortical abnormalities, but do not provide specific information about the pisiform bone or its volar aspect.
  • The pisiform bone is a small, pea-shaped bone in the wrist, and cortical irregularities in this area could be related to various conditions, but the provided studies do not offer relevant insights.

Available Data

  • There is no direct evidence in the provided studies to determine the location or significance of subtle cortical irregularity at the volar aspect of the pisiform.
  • Further research or consultation of additional studies may be necessary to gather more information on this topic.

References

Guideline

acr appropriateness criteria<sup>®</sup> acute hand and wrist trauma.

Journal of the American College of Radiology, 2019

Guideline

acr appropriateness criteria<sup>®</sup> acute hand and wrist trauma.

Journal of the American College of Radiology, 2019

Guideline

acr appropriateness criteria<sup>®</sup> acute hand and wrist trauma.

Journal of the American College of Radiology, 2019

Research

Osteoid osteoma: Contemporary management.

Orthopedic reviews, 2018

Research

Magnetic resonance imaging of benign bone lesions: cysts and tumors.

Topics in magnetic resonance imaging : TMRI, 2002

Research

Nonsteroidal anti-inflammatory drugs and bone mineral density in older women: the Rancho Bernardo study.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.