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Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Updated: Mar 24, 2026

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Kinematics of the Distal Radioulnar Joint: A Dynamic CT Analysis.

Euphemia Li1, Gregory I Bain2, Simon B M MacLean1

  • 1Department of Orthopaedic Surgery, Tauranga Hospital, Tauranga South, Tauranga, New Zealand.

Journal of Wrist Surgery
|March 23, 2026
PubMed
Summary

The distal radioulnar joint (DRUJ) ulnar head stays dorsal during rotation, moving volarly towards supination. Loading and deviation dynamically alter the DRUJ gap, impacting surgical management of instability.

Keywords:
4D-CTdistal radioulnar jointinstabilitykinematicsmorphology

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Radiology

Background:

  • Distal radioulnar joint (DRUJ) kinematics are complex and poorly understood, with current knowledge limited by cadaveric and static imaging.
  • Defining normal DRUJ anatomy and kinematics is crucial for managing DRUJ pathology.
  • This study aimed to define normal DRUJ kinematics using dynamic computed tomography (CT).

Purpose of the Study:

  • To investigate the kinematics of the distal radioulnar joint (DRUJ) in normal wrists.
  • To analyze the relationship between DRUJ anatomy and its dynamic motion.
  • To provide data for improved surgical management of DRUJ pathologies.

Main Methods:

  • Retrospective cohort study of 38 wrists using dynamic CT scanning.
  • Measurement of sigmoid notch and ulnar head dimensions and morphology.
  • Quantification of ulnar head translation during forearm rotation (pronation to supination).
  • Assessment of ulnar variance and sigmoid notch gap under different loading conditions (relaxed vs. clenched fist) and wrist deviations.

Main Results:

  • The ulnar head consistently remained dorsal to the sigmoid notch midpoint throughout forearm rotation, becoming relatively more volar from pronation to supination.
  • Ulnar variance and sigmoid notch gap were dynamic, significantly changing with wrist deviation and fist clenching.
  • No significant association was found between sigmoid notch morphology and measured kinematic parameters.

Conclusions:

  • The ulnar head's dorsal position relative to the sigmoid notch changes dynamically with forearm rotation.
  • Ulnar variance and sigmoid notch gap are influenced by wrist loading and deviation, offering insights into joint stability.
  • Findings have implications for surgical reconstruction of DRUJ instability, though further research on morphology-kinematics relationships is needed.