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Pisiform arthritis (wrist)

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Posted 3/10/2006 4:03 AM (GMT 0)
Has anyone had a problem with the pisiform in their wrist? I am in a lot of pain and was just "diagnosed" today by a ortho surgeon who told me he has never seen this problem before. He never even asked about my arthritis but after I left, I went to the internet and found some info about it. I have Crohn's and joint pain (arthritis) in most of my body with my hands being the worst part. I read an article that stated removal of the pisiform bone is very successful in relieving pain. Has anyone else experienced this? The pisiform is in the wrist on the pinky finger side.
Laura
Posted 3/10/2006 4:15 AM (GMT 0)
Hi RuskyBiz! :) Welcome! Is that the little knob that sticks out on the outside of your wrist? I've never heard of having it removed... I need to google it...! :)
Posted 3/11/2006 1:39 AM (GMT 0)
yes, that would be the one!!
Posted 3/11/2006 1:42 AM (GMT 0)
Wait-----I should have thought about that before I replied. The pisiform is on the underside of the wrist. If you are looking at the palm of your hand, it would be straight down from your pinky finger. It's not the knob on the top of your wrist.
Posted 4/25/2006 11:32 PM (GMT 0)
Hi

New to the group but am also having problems with my Pisiform bone. Have a lot of pain in that bone and moving my hand to the left causes more pain, plus shooting pains in the pinky. My hand surgeon is considering removing this bone. Has anyone had theirs removed and if so what are the limitations? I have something called avascular necrosis of the lunate bone in my right wrist (also called Kienbock's)
Posted 4/27/2006 6:00 PM (GMT 0)
hi & welcome to you both to HW!  look at that, throw the line in and get 2 catches!

i have to stress that the best thing is to be evaluated and treated by a hand specialist for this like samskid is.

hand surgeons are specialized in a very intricate and delicate field.  i mean, look at how many bones there are in the hand! it's amazing.

 

some anatomy for all who pass this:

"pisiform" basically means pea shaped.  and this little bone is the smallest of the sesamoid series of bones in the hands.

 

knowing the anatomy of the hand, i would think that having surgery & getting it removed would not interfere or disrupt any motor function of the hand.

of course PT and ocupational therapy may be needed.

 

unfortunatley i do not know of anyone personally who has had this specific procedure  done...but i will keep bumping this thread to the top of the forum so a paserby is more likely to see it...and hopefully we'll get someone who HAS HAD it done!

 

i do know of someone who had every joint replaced in his hand, from RA, and has remarkable results and pretty much full function and NO PAIN! so that's encouraging.

 

so Rusky, like sam is...i would try to see if there is a hand surgeon or hand specialist that you can consult with...they are the best at this.

 

take good care

erin

Posted 4/29/2006 11:20 AM (GMT 0)
Hi Erin:

Thank you for your response. Hopefully someone out there who has had a pisiformectomy will answer. I have had full fusion on my other wrist this past summer with discouraging results so I am very curious as to what lies ahead if my pisiform bone is removed. The fusion was a results of Kienbocks (which from what I've read is a form of arthritis - although I have my doubts about that). Kienbock's is basically when the lunate bone in your wrist "dies" causing a lot of pain and loss of range of motion in your wrist.

Laura, as Erin suggested, the best thing to do would be to find a Hand Specialist, who deals specifically with the hand/wrist area. Based upon what little knowledge I've picked up over the years with regards to the hand/wrist you definitely want someone who has that type of experience. Did the ortho suggest any other type of treatment? I was given 3 sets of cortisone shots (which do not seem to be working). I do find that if I ice it - it helps with the pain to some degree.

After I heard the word "surgery" my brain went on hold (lol) and I didn't ask the questions I should have. I will see her again in the next month so hopefully by then I will remember to ask all the pertinent questions I need to.

Thanks again

Jean
Posted 5/1/2006 1:10 PM (GMT 0)
oh i know, i looked up and read about Kienbocks in my nursing texts...it's pretty rare! you'e been through a lot. i can only inagine how painful thathad to have been.
i too hope someone comes across this post.
are any of you close to New York City? there are several hand surgery specialists, world renound one's at that too. and centers for bone & joint diseases and special surgeries.
bless you both....hang in there.
sincerely,
erin
Posted 5/3/2006 11:01 PM (GMT 0)
BUMP
Posted 5/4/2006 3:24 AM (GMT 0)

Hi Erin:

Yes, I am close to NYC - I live in Northern NJ.  I am going to a hand surgeon in Englewood and she does have experience with Kienbock's (luckily for me)  She actually "fixed" my fusion to some degree.  The first surgeon I had did what I consider to be a failed surgery but the doctor I am seeing currently removed the plate that was too big for my wrist, fixed an impacted ulna bone and also removed bone chips.  Unfortunately, it seems that the problem with my pisiform started exactly at the same time I started having more problems and pain from KD, so it was pretty much the feeling that the pain I was experiencing was from overcompensating for my right wrist.  It seems like when it flares up that my bone is on fire - that's really the only way I can describe it.  There is a history of osteoarthritis in my family - it pretty much goes back as far as I can trace my family tree, so I'm assuming that it's arthritis that is causing the pain.  I did have an MRI a year ago and was told at that time that I had ganglion cysts in that wrist but from what both doctors have told me - they shouldn't be causing the pain that I'm experiencing.  The burning sensation is very similar to the pain that KD causes as well but I've been assured that I don't have bilateral KD (which I consider to be a real good thing!).

Any advice or suggestions you might have - or even doctor recommendations (doesn't hurt to get a 2nd opinion) is welcome.

Thanks, again

Jean

Posted 1/6/2007 3:44 PM (GMT 0)
 Hi All,

    I am new also and was trying to get information on the removal of the pisiform bone also. I have had since 2002,torn ligament repair, carpal turnnel, shorten of the ulnar bone with a plate put in, remvoal of the plate, and now the removal of the pisiform. I will let you all know how things progress after surgery. I am going in this Tuesday 1-9-2007.I have heard some people lose some mobilety and others are fine.

                   Teresa

Posted 1/6/2007 4:49 PM (GMT 0)

Hi Teresa

Good luck with the pisiform removal.  I had mine done in September and on my left wrist in October.  Once the bone was removed on my right wrist (which is fused) the pain was gone immediately.  My left wrist is taking longer to heal, probably because it wasn't immobilized after the surgery (I did have a splint, but it wasn't casted after that).  I did not lose any mobility in my left wrist and you can't even tell it's gone other than the scar which isn't too bad.  The shape of my hand hasn't changed.  You wouldn't know it unless I turn it palm side up and then you would see the scar.

Did you have Kienbock's disease (avascular necrosis of the lunate bone)?  From the surgeries you described it sounds like you've been treated for it.  i.e. shortening of the ulna, etc. 

If I can answer any questions on the pisiform removal or Kienbock's, let me know.

Hope this helped.

Regards,

Jean

Posted 1/7/2007 3:36 PM (GMT 0)

 Hi Jean,

  Thanks for the info. I think the doc. said pisiform arthirtis. This all statred with cracking my wrist at work.I hope I also don't lose any mobility. I will let you know more when I can type, cause it is my primary hand. And by the way I am not a good speller.

 Thanks again,

  Teresa

Posted 1/8/2007 1:21 AM (GMT 0)

Hi Teresa

Don't worry about the spelling!  You should see my handwriting - it looks like a doctor's!!

Anyway, good luck with your surgery.  I hope all goes well for you.

While you're there, you might want to ask the dr. about kienbock's or avascular necosis of the lunate because it can be caused by an injury.  The lunate bone shows up white on an x-ray and black on an MRI.  It's caused by lack of blood supply to the bone.

Post when you can and just remember to ice and elevate after the surgery.  It will definitely help.

Good luck.

Jean

Posted 1/12/2007 6:46 PM (GMT 0)
Hi Jean,

I was wondering after your surgery, the first visit did they put a cast on or did you just go to therapy? Just wondering what to look forwards to.

I am doing good just some pain but I am use to that. Hope to hear from you soon, and thank you for taking time to talk to me.

Thanks aigan,

Teresa
Posted 5/5/2011 10:22 PM (GMT 0)
RuskyBiz
I have had arthritis most of my life and I am 42.  We adopted a Military Working Dog and he dislocated my wrist and it has taken me almost 2 years to find something that helped.  I only had 2 injections between my pisiform bone and the one near/next to it.....but it only lasted 6 months.  I am having surgery May 20th of this year and I hear it's fairly easy and takes a majority of your pain away even though you may still have a little pain----but my Ortho doc said it should (after removing it) take away at least 80-85% of my pain and I am happy with that.

Hope this helps and I'll post something after my surgery!

Posted 7/30/2011 1:13 AM (GMT 0)
I just scheduled surgery to remove both my Pisiform bones in my right hand and then the left. The right hand is scheduled for August 30 and the left is scheduled for September13th unless my Lumbar back fusion (L5-S1) takes precedence first. I have already had surgery to replace both knees, the base of both thumbs and my right shoulder, all due to arthritis!!! Thanks and new to the forum! Tom
Posted 7/30/2011 2:25 AM (GMT 0)
To both TDWGROMKO and TommyH
Nice to meet you both and welcome to HW...
You've found an older posting from 2006, and while it's good to read, I'm not sure if
RuskyBiz or Erin are still on here posting anymore...
Please start a new thread and introduce yourselves...we'd like to meet you both.
TommyH sure hope you got your surgery done by a hand expert...
also there might be more information about this on a google search, but please do keep us informed about
your surgery date, so we can send you both well wishes...
this is a good forum...
TommyH get a second opinion on the lumbar back surgery, as I've been told once surgery always surgery
and that's major surgery hun and will keep you laid up for several weeks...look at older posts in the chronic pain forum on
for spinal surgeries...many there have had them done...well wishes indeed on that...
Hope this helps you both Thanks
Posted 12/9/2011 1:36 AM (GMT 0)
Hey everyone, i am new on here and just looking for some info on pisiform removal. I am only 18 and I am having my pisiform bone taken out on Monday December 12th, 2011. The 3 specialists I have seen have no clue what to do, so I am wondering if this is even the right fix. If anyone has had this done I would like to know how much mobility I will loose, because I play college softball and would like to continue.

Thanks for the help!
Posted 12/13/2011 4:13 PM (GMT 0)
I had my left pisiform removed a long time ago (1989?). I'd been treated for tendonitis in my wrist for a year before the doctors finally sent me to a hand specialist who did a bone scan (in Washington DC) and determined my pisiform was CHIPPED and creating the tendonitis. They removed the bone under a anesthetic block and I felt IMMEDIATE relief from the pain I'd been experiencing. I did go to PT for a few visits for range of motion. I was never put into a cast, but I have about a 1.5" scar at the base of my wrist in the crease - not even noticable! Other than my left wrist being weaker than the other after the surgery, I have had no ill effects.
Up until now, that is. I believe I may be experiencing arthritis in the joint as a result of the surgery. Is this possible? My wrist aches at that same location for about the last two months. It is worse the more I work at my computer (my job).
Posted 2/21/2012 4:42 AM (GMT 0)
    I had surgery in 1996 the cause of Kienbock Diease, a lunate bone collapas in my Rt wrist.By placing a plate....yrs later 2007 had lot problems lots pain the type of work I do. The hand surgeron removed the plate/screws. Told me that I cannot do the pyhiscal work that,I do anymore. Now after all this time I was told with this kind of surgery,that I had I will always have Arthristis. I can say dealing w/this  I learned that I can't do certain things,just work around it. Till this day I do have alot of pain, am not a asprin person or pill taker. I wanted to know if anyone has gone threw,or simlar case. I'm planning to see my Hand Surgeron soon,living like this really stinks.  Thanks..........
Posted 2/26/2012 1:13 AM (GMT 0)
I have just had my pisoform removed and was wondering how long is recovery. Eg going to work, using hand for carrying, typing etc. when does swelling go down and pain stop?

It is good to hear that it has been successful for others on the forum. thanks

Posted 3/28/2012 7:13 PM (GMT 0)
Hi, just been told that I'm having this done in April, and can't find much info about it. So relieved to find this!! Just wondered how long people generally had off work and how long you couldn't drive for. Have a two year old, so trying to plan my life and panicking!

Thanks.
Posted 4/17/2012 12:37 AM (GMT 0)
Muggie-My fiance just had her pisiform (LH) removed about 2 weeks ago & to be honest, its too early to say just how long her recovery will take. The ortho told her she would be out of work approx 3-4 weeks (she works at a hospital) and after her first postop visit, the ortho said 2-3 months. The pain & recovery for each person is different but her current pain and numbness is a major concern. She is 40, in good health and from all the research we did prior to the surgery, this wasnt expected. We are just taking it one day at a time. Plus the ortho only gave her (5) vicidon for after the surgery. Based on his findings, most people dont even take meds after! lol. I would plan for at least a month - based on what I have seen. I hope that I can get info on what is the next step if she doesnt get better?!? Godspeed in your recovery.
Posted 4/18/2012 6:16 PM (GMT 0)
Thanks for the information, I'm having the operation on Friday and I'm getting more nervous as the day gets closer. I'm sure it'll all be okay, but having nerve damage in my foot from a previous operation, you never know. Sorry to hear about all of the problems your fiancee is having, I hope it begins to settle down soon. I think I'd be lynches if I ended up having three months off work!!!

 

Let me know how she gets on.

 

Muggie.

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