A simple method of physical examination for the diagnosis of distal radioulnar joint incongruity

Abstract

Distal radioulnar articulation is one of the most complex structures in the wrist. The normal relationship between the radius and the ulna relies on a delicate balance between the two articular surfaces. When diagnosing the cause of ulnar-sided wrist pain, assessing the congruency of the articulation presents a challenge for the physician. The clinical examination of the distal radioulnar joint (DRUJ) usually includes direct palpation of the dorsal aspect of the joint, grinding the radius and ulna by lateral compression, or use of the chuck test to determine the stability of the triangular fibrocartilage (TFC) ligaments. In chronic conditions, these tests may reveal articular incongruity through crepitus and pain. However, in the early stages of DRUJ arthritis, clinical findings usually are subtle, and radiological findings may not always be positive [1]. The purpose of this paper is to present a test that can help the physician diagnose DRUJ pathologies in the early stages.