Osteochondroma of the pisiform: A case report

Figure 1  Radiographs suggestive of an elongated ossified mass arising from the volar aspect of the pisiform bone (orange arrow marked).

Figure 2 Computed tomography scan demonstrated a well-circumscribed lesion and a small bump ventrally suggestive of pisiform (pisiform with dorsal osteochondroma) with no stalk and no periosteal reaction (3D computed tomography marked). A-C: Various views of the wrist (anteroposterior and oblique) and the orange arrow pointing the lesion.

Figure 3 Magnetic resonance imaging. A-F: T1 coronal with hyointense lesion marked (B); T2 coronal with oedema of the pisiform and triquetrum without adjacent soft tissue infiltration marked (C); T1 sagittal with hypointense lesion marked (cartilage caps are hypointense in T1) (D); T1 axial with hypointense lesion marked and ventral isointense lesion suggestive of pisiform (orange arrow) with dorsal lesion (blue arrow) (A, E and F).

Figure 4 The excised pisiform with osteochondroma along with histopathological examination, with cartilage cap and bone marrow elements marked which was suggestive of the osteochondroma. A and B: Histopathological examination, 4 × (A) and 40 × (B); C: The excised pisiform with osteochondroma.

Figure 5  A 5 cm Bruner incision was made and centered over the flexor carpi ulnaris.

Figure 6 After superficial dissection through palmar aponeurosis, the flexor carpi ulnaris tendon was identified and retracted radially, revealing the underlying osteochondroma. A: The flexor carpi ulnaris tendon was identified and retracted radially; B: Underlying osteochondroma.