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Subtle radiographic findings of acute, isolated distal radioulnar joint dislocation

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Abstract

Distal radioulnar dislocations typically occur in association with fractures of the distal radius and/or ulna. Rare isolated dislocations or subluxations are more difficult to diagnose and are initially missed in up to 50 % of cases. We present two cases of missed isolated volar rotatory dislocation of the distal radioulnar joint. Subtle, overlooked radiographic findings of abnormal radioulnar alignment and ulnar styloid projection are highlighted. The supplemental role of cross-sectional imaging is reviewed. Adequate clinical information, appropriate radiographic technique, and high index of suspicion are necessary for the accurate and timely diagnosis of this rare injury pattern.

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References

  1. Ehman EC, Felmlee JP, Frick MA. Imaging of the proximal and distal radioulnar joints. Magn Reson Imaging Clin N Am. 2015;23:417–25.

    Article  PubMed  Google Scholar 

  2. Amrami KK, Moran SL, Berger RA, Ehman EC, Felmlee JP. Imaging the distal radioulnar joint. Hand Clin. 2010;26:467–75.

    Article  PubMed  Google Scholar 

  3. Goldfarb C, Yin Y, Gilula LA, Fisher AJ, Boyer MI. Wrist fractures: what the clinician wants to know. Radiology. 2001;219:11–28.

    Article  CAS  PubMed  Google Scholar 

  4. Heiple KG, Freehafer AA, Vant Hof A. Isolated traumatic dislocation of the distal end of the ulna or distal radio-ulnar joint. J Bone Joint Surg Am. 1962;44A:1387–94.

    Google Scholar 

  5. Singletary EM. Volar dislocation of the distal radioulnar joint. Ann Emerg Med. 1994;23:881–3.

    Article  CAS  PubMed  Google Scholar 

  6. Mittal R, Kulkarni R, Subsposh SY, Giannoudis PV. Isolated volar dislocation of distal radioulnar joint: how easy to miss! Eur J Emerg Med. 2004;11:113–6.

    Article  PubMed  Google Scholar 

  7. Schiller MG, Ekenstam FA, Kirsch PT. Volar dislocation of the distal radio-ulnar joint. J Bone Joint Surg Am. 1991;73A:617–9.

    Google Scholar 

  8. Garrigues GE, Aldridge JM. Acute irreducible distal radioulnar joint dislocation: a case report. J Bone Joint Surg Am. 2007;89:1594–7.

    Article  PubMed  Google Scholar 

  9. Asopa V, Douglas RJ, Saies AD, Church JS. A misdiagnosis of traumatic hypersupination of the distal radioulnar joint: a case report. Case Rep Orthop. 2013;2013:1–3.

    Article  Google Scholar 

  10. Mulford JS, Jansen S, Axelrod TS. Isolated volar distal radioulnar joint dislocation. J Trauma Inj Infect Crit Care. 2010;68:E23–5.

    Article  Google Scholar 

  11. Kumar A, Iqbal MJ. Missed isolated volar dislocation of distal radio-ulnar joint: a case report. J Emerg Med. 1999;17:873–5.

    Article  CAS  PubMed  Google Scholar 

  12. Kleinman WB. Stability of the distal radioulna joint: biomechanics, pathophysiology, physical diagnosis, and restoration of function what we have learned in 25 years. J Hand Surg. 2007;32A:1086–106.

    Article  Google Scholar 

  13. Wijffels MM, Brink PR, Schipper IB. Clinical and non-clinical aspects of distal radioulnar joint instability. Open Orthop J. 2012;6:204–10.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Szabo RM. Selected The American Academy of Orthopaedic Surgeons. J Bone Joint Surg Am. 2006;88A:884–94.

    Google Scholar 

  15. Nicolaidis S, Hildreth DH, Lichtman DM. Acute injuries of the distal radioulnar joint. Hand Clin. 2000;16:449–59.

    CAS  PubMed  Google Scholar 

  16. Carlsen BT, Dennison DG, Moran SL. Acute dislocations of the distal radioulnar joint and distal ulna fractures. Hand Clin. 2010;26:503–16.

    Article  PubMed  Google Scholar 

  17. Morrissy RT, Nalebuff EA. Dislocation of the distal radioulnar joint: anatomy and clues to prompt diagnosis. Clin Orthop Relat Res. 1979;144:154–8.

    PubMed  Google Scholar 

  18. Nakamura R, Horii E, Imaeda T, Tsunoda K, Nakao E. Distal radioulnar joint subluxation and dislocation diagnosed by standard roentenography. Skelet Radiol. 1995;24:91–4.

    Article  CAS  Google Scholar 

  19. Nakamura R, Horii E, Imaeda T, Nakao E. Criteria for diagnosing distal radioulnar joint subluxation by computed tomography. Skelet Radiol. 1996;25:649–53.

    Article  CAS  Google Scholar 

  20. Mino DE, Palmer AK, Levinsohn M. The role of radiography and computerized tomography in the diagnosis of subluxation and dislocation of the distal radioulnar joint. J Hand Surg. 1983;8:23–31.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, H066, Milton S. Hershey Medical Center, 500 University Drive, P.O. Box 850, Hershey, PA, 17033, USA

    Dennis M. Duryea

  2. Bone and Joint Institute, Milton S. Hershey Medical Center, 30 Hope Drive, Hershey, PA, 17033, USA

    Alexander H. Payatakes & Timothy J. Mosher

Authors
  1. Dennis M. Duryea
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  2. Alexander H. Payatakes
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  3. Timothy J. Mosher
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Correspondence to Dennis M. Duryea.

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Duryea, D.M., Payatakes, A.H. & Mosher, T.J. Subtle radiographic findings of acute, isolated distal radioulnar joint dislocation. Skeletal Radiol 45, 1243–1247 (2016). https://doi.org/10.1007/s00256-016-2411-x

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  • DOI: https://doi.org/10.1007/s00256-016-2411-x

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