distal radioulnar joint dislocation

Isolated distal radioulnar joint (DRUJ) dislocations are rare and are more commonly part of complex forearm fracture-dislocations.

Clinical presentation

Wrist pain, swelling and deformity following FOOSH or direct trauma. The patient will be unable to supinate/pronate the forearm .

Pathology

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 displaced. If more than 50% of the articular surfaces do not articulate, then the term DRUJ subluxation is used .

Associated injuries include :

  • tear of the dorsal radioulnar ligament of the TFCC
  • disruption of the dorsal DRUJ capsule

Radiographic features

This injury is typically described by the position of the ulna compared to the radius .

Plain radiograph
  • true lateral radiograph of the wrist is vital (as little as 10º of rotation can result in misinterpretation)
  • widened distal radioulnar joint space on frontal projections, with dislocation/subluxation evident on lateral projections

Related pathology

DRUJ dislocations are also part of Galeazzi and Essex-Lopresti injuries.

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