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 is more commonly displaced dorsally (i.e. the distal ulna is dorsally dislocated with respect to the distal radius), but can be volarly displaced1. 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