How is a distal radioulnar joint (DRUJ) arthritis etiology of ulnar-sided wrist pain diagnosed and treated?

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

Answer

Distal radioulnar joint (DRUJ) arthritis may arise from various sources, such as repetitive injury, previous trauma with deformity, or systemic disease (eg, RA). The patient may complain of decreased grip strength, pain, clicking, or decreased range of motion. Physical examination reveals pain with forearm pronation and supination. Squeezing the ulna and radius together often produces pain, crepitation, or snapping.

Plain radiographs may reveal osteophytes, joint-space narrowing, deformity, or subchondral cysts. When radiographic findings are negative, computed tomography (CT) of the DRUJ may reveal degenerative changes of the ulnar head.

Conservative treatment includes rest, use of NSAIDs, immobilization, and steroid injections. If conservative treatment fails, surgical options include hemiarthroplasty, ulnar head excision (Darrach), or osteotomy/fusion (Sauve-Kapandji) procedures.


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