Computed tomography for the detection of distal radioulnar joint instability: normal variation and reliability of four CT scoring systems in 46 patients

• DOI: 10.1007/s00256-016-2455-y
• Publication Date: 2016-08-23T23:35:49Z
• Authors: Mathieu Wijffels; Wouter Stomp; Pieta Krijnen; Monique Reijnierse; Inger Schipper
• Keywords: Druj; Subluxation

The diagnosis of distal radioulnar joint (DRUJ) instability is clinically challenging. Computed tomography (CT) may aid in the diagnosis, but reliability and normal variation for DRUJ translation on CT have not been established detail. aim this study was to evaluate inter- intraobserver agreement ranges scoring methods determination both posttraumatic uninjured wrists.Patients with a conservatively treated, unilateral radius fracture were included. scans wrists evaluated independently, by two readers using line method, subluxation ratio epicenter method method. assessed values determined based wrists.Ninety-two wrist CTs (mean age: 56.5 years, SD: 17.0, mean follow-up 4.2 0.5) evaluated. Interobserver best [ICC = 0.73, 95 % confidence interval (CI) 0.65-0.79]. Intraobserver almost perfect (ICC 0.82, CI 0.77-0.87). Each showed wide range translation. Normal -0.35 -0.06 pronation -0.11 0.19 supination.DRUJ pro- supination can be reliably wrists, however large variation. seems most reliable. Scanning might helpful prevent radiological overdiagnosis instability.