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The distal radioulnar articulation [1] (also known as the distal radioulnar joint, [2] or inferior radioulnar joint [1] [3]) is a synovial pivot joint between the two bones in the forearm; the radius and ulna. It is one of two joints between the radius and ulna, the other being the proximal radioulnar articulation.
DRUJ stress test: With this provocation maneuver, the wrist is held in pronated or supinated position, while the physician attempts to manipulate the distal ulna in dorsal and volar direction. Painful laxity indicates DRUJ instability and suggests RUL pathology. [2] Ulnar grind test: The forearm is fixated and the wrist is held in dorsiflexion.
The distal radioulnar joint (DRUJ) is a pivot joint located between the distal ends of the radius and ulna, which make up the forearm.Formed by the head of the ulna and the ulnar notch of the radius, the DRUJ is separated from the radiocarpal (wrist) joint by an articular disk lying between the radius and the styloid process of the ulna.
The major exception is when the joint between these bones, the distal radioulnar joint (or DRUJ), is unstable. When the DRUJ is unstable, the ulnar styloid may require independent treatment. An excessively long styloid process of the ulna can cause painful contact with the triquetral bone in the wrist, known as ulnar styloid impaction syndrome. [1]
The injury can be difficult to diagnose initially as medical attention is usually focused on the injury to the radial head, leading to the distal radio-ulnar injury being overlooked. The examination finding of tenderness of the distal radio-ulnar joint suggests an Essex-Lopresti injury in patients who have sustained high energy forearm trauma.
The interosseous membrane is composed of 5 ligaments:- Central band (key portion to be reconstructed in case of injury)- Accessory band- Distal oblique bundle- Proximal oblique cord- Dorsal oblique accessory cord. Severe forearm injuries involving separation of the radius and ulna may be due to rupture of the interosseous membrane.
Adults with Madelung’s deformity may suffer from ulnar-sided wrist pain. Madelung's Deformity is usually treated by treating the distal radial deformity. However, if patients have a positive ulnar variance and focal wrist pathology, it’s possible to treat with an isolated ulnar-shortening osteotomy.
Joints of the hand, X-ray. The bones in each carpal row interlock with each other and each row can therefore be considered a single joint. In the proximal row a limited degree of mobility is possible, but the bones of the distal row are connected to each other and to the metacarpal bones by strong ligaments that make this row and the metacarpus a functional entity.
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