OsteoMenagerie 5: The pisiform

The pisiform is one of the smallest bones you’re likely to come across when dealing with archaeological remains (though I once found one of the auditory ossicles when excavating a commingled burial site in Portugal – that was an exciting afternoon, lemme tell you); as such, it can occasionally be confused with the smaller, unnamed sesamoid bones of the hand or foot. If you have a particularly devious individual compiling your bone quizzes, it pays to know the difference. Luckily, a few simple tips can help you tell the distinguish the pisiform from impostor sesamoids.

First and foremost, the pisiform bears a striking resemblance to one of our great American megafauna: the bison. To wit:

Left: The right pisiform, from various angles. Right: The majestic bison.

Left: The right pisiform, from various angles.
Right: The majestic bison.

The tag “superior” in the set of drawings above refers to anterior view in SAP – basically, it’s what you would see if you flipped your palm up in supination and looked down at your carpals. To orient you, from this perspective the pisiform will be sitting on the side of your wrist that is closest to Ray 5, your little finger.

That's a delicious salted caramel from Madrid, in case inquiring minds were wondering.The rugose, ‘superior’ surface of the pisiform visible in this view is suggestive of the hump and head of a bison. While it’s easiest to see the bovid resemblance in proximal or distal view, another distinctive and diagnostic feature of the carpal is its round and decidedly flat articular surface for the triquetral.

For_triquetralThis facet will help even the novice osteologist distinguish the pisiform from its most pernicious mimics, namely:

(i) The lunate:  The lunate’s concave articular facet for the capitate is easily distinguised from the flattened, circular or oval facet for the triquetral on the pisiform.  Also, the lunate will be much larger.                                  (ii) Sesamoids: The various small sesamoid bones of the hands and feet  are much less regular in form, and lack this distinctively flat articular surface

Siding Tips: Unfortunately, I’ve never found a reliable method for siding the pisiform, and I have yet to meet an osteologist who is passionately invested in discovering one. In his description of the pisiform, White notes that “The morphological variation of this bone makes siding accurate in only about 85-90% of all cases” (White et al., 2012: 205).  He then provides a siding technique that doesn’t work on the bone photographed, which is telling. If Tim White doesn’t side something. I don’t side it either. JB out!


White, Tim D., Michael T. Black & Pieter Folkens. 2012. Human Osteology. 3rd Edition. Academic Press.

Images of bison found here: 1 & 2 & 3 & 4
Sketch of articular facet for triquetral  found here.

This entry was posted in Carpals, Hand, Osteology, OsteoMenagerie and tagged , , . Bookmark the permalink.

1 Response to OsteoMenagerie 5: The pisiform

  1. Alice Wright says:

    When I next see you, I will take you on a fantastical photo journey of all of the baby bison I met at Yellowstone in June. It will simultaneously delight you and destroy your,life. (PS, great post!)


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.