Distal radius x-ray

Checklist

• Is there loss of normal anatomy (e.g. fx 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 fx
• Radial height (Distance between distal tip of radial styloid and articular surface of the radius)
  • Normal ~ 10-17mm
    • Often smaller with comminuted or impacted fx
• 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 fx

Oblique

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