Distal radioulnar joint dislocation
Isolated distal radioulnar joint (DRUJ) dislocations are rare and are more commonly part of complex forearm fracture-dislocations.
Wrist pain, swelling and deformity following FOOSH or direct trauma. The patient will be unable to supinate/pronate the forearm 1,2.
Distal radioulnar joint dislocation may be dorsal (more common) or volar 1. If more than 50% of the articular surfaces do not articulate, then the term DRUJ subluxation is used 3.
Associated injuries include 4:
- tear of the dorsal radioulnar ligament of the TFCC
- disruption of the dorsal DRUJ capsule
- true lateral radiograph of the wrist is vital (as little as 10º of rotation can result in misinterpretation) 2
- widened distal radioulnar joint space on frontal projections, with dislocation/subluxation evident on lateral projections
- 1. Thomas BP, Sreekanth R. Distal radioulnar joint injuries. Indian J Orthop. 2012;46 (5): 493-504. doi:10.4103/0019-5413.101031 - Free text at pubmed - Pubmed citation
- 2. Squires JH, England E, Mehta K et-al. The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna. AJR Am J Roentgenol. 2014;203 (1): 146-53. doi:10.2214/AJR.13.11573 - Pubmed citation
- 3. Emergency Radiology. Springer. (2007) ISBN:3540689087. Read it at Google Books - Find it at Amazon
- 4. Conaghan PG, O'Connor P, Isenberg DA. Musculoskeletal Imaging. Oxford University Press. ISBN:0199235775. Read it at Google Books - Find it at Amazon