How is the physical exam of the distal radioulnar joint (DRUJ) performed in the evaluation of ulnar-sided wrist pain?

Updated: Nov 22, 2019
  • Author: David M Lichtman, MD; Chief Editor: Harris Gellman, MD  more...
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Answer

Answer

Physical examination of the DRUJ should begin with examination of the contralateral wrist to note any ulnar variance or inherent joint instability of the individual. Evaluation of the DRUJ begins with palpation over the distal radius and lunate articulation that proceeds ulnarly to the sigmoid notch and distal ulna. Pain that occurs with forearm pronation and supination may suggest DRUJ disease. The examiner must be careful to rotate the forearm at the wrist, not at the hand. Squeezing the ulna and radius together causes pain, crepitation, or a snap in a patient with DRUJ disease. The examination should be performed in various stages of pronation and supination to detect ulnar-head chondromalacia or a small cartilaginous flap.


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