Abstract
Background Pisotriquetral (PT) loose bodies have been described in the literature only a few
times as case reports. While PT pathology remains the differential for ulnar-sided
wrist pain, it can often be difficult to diagnose, as symptoms can be variable and
radiographic imaging may be negative for any findings.
Case Description A 24-year-old major league baseball player presented with pain and locking of his
wrist during follow through of his bat swing. Plain radiographic imaging, as well
as computed tomography (CT) imaging, was negative for any pathology. Dynamic magnetic
resonance imaging (MRI) demonstrated a loose body which entered the PT joint when
the wrist was moved into a flexed position. This caused entrapment of the loose body
and locking of the wrist.
Literature Review A total of 17 reported patients in the literature have been diagnosed with a PT loose
body. The clinical examination findings, radiographic findings, and surgical findings
are reviewed.
Case Relevance PT loose bodies can present a challenging clinical picture to diagnose. The purpose
of this case report is to review the appropriate clinical workup, including common
examination findings and advanced imaging techniques, to help the clinician with the
diagnosis.
Keywords
pisotriquetral joint - loose body - locked wrist
