Distal radius x-ray

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Checklist

  • Is there loss of normal anatomy (e.g. fracture displacement or angulation, loss of radial height)
  • Is there involvement of the radiocarpal or distal radioulnar joint?
  • Is there discontinuity of the articular surface or diastasis (separation) of the articular fragments?
  • Are high-risk features present (severe comminution, articular step-off >2 mm, fracture-dislocation)?

Specific Views

PA

  • Radial inclination (angle between line perpendicular to long axis of radius and line between radial styloid and ulnar corner of lunate fossa)
    • Normal = 15-25 degrees
      • Often smaller with fracture
  • Radial height (Distance between distal tip of radial styloid and articular surface of the radius)
    • Normal ~ 10-17mm
      • Often smaller with comminuted or impacted fracture
  • Ulnar variance (Distance between ulnar-side articular surface of radius and the ulnar carpal surface)
    • Normally 1-2mm

Lateral

  • Palmar Tilt (angle between line perpendicular to long axis of radial shaft and line through the apices of the palmar and dorsal rims of the radius
    • Normally 10o-25o
      • Often smaller with fracture

Oblique

  • May reveal intra-articular involvement not seen on other views

See Also

References