Degenerative arthritis of the pisotriquetral joint was diagnosed by point tenderness over the pisiform and crepitus elicited by lateral movement of the pisiform on the triquetrum. It was confirmed by a roentgenogram of the wrist (lateral view in 30 degrees supination) and injection of the pisotriquetral joint with local anesthetic. Excision of the pisiform resulted in complete relief of pain.