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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.
The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation. Evaluation of distal pulses; Strength testing: wrist extension tests the radial nerve, finger abduction tests the ulnar nerve, and thumb apposition tests the median nerve.
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.
Activities that use forceful wrist extension such as rising from a chair or push-ups may be painful. In the absence of gout, chondrocalcinosis, rheumatoid arthritis, or prior distal radius fracture, a person with gradual onset limited motion and pain in the wrist likely has wrist osteoarthritis. [citation needed]
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]
Half of nonosteoporotic patients will develop post-traumatic arthritis, specifically limited radial deviation and wrist flexion. This arthritis can worsen over time. [6] Displaced fractures of the ulnar styloid base associated with a distal radius fracture result in instability of the DRUJ and resulting loss of forearm rotation. [citation needed]
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.
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.
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