[Clinical examination of the distal radioulnar joint].

BACKGROUND

The distal radioulnar joint (DRUJ) provides the distal link between radius and ulnar and is the centre of rotation during pronation and supination. Pronation and supination are essential in controlling the posture and optimal presentation of the hand to grasp an object. In addition, pronation and supination enable us to rotate tools when they are in the longitudinal axis of the forearm. Due to this, the DRUJ plays a central role in the performance of activities in daily life.

DIAGNOSTICS

Examination of the ulnar-side of the wrist remains challenging for hand surgeons due to a wide range of pathologies with overlapping clinical symptoms. Therefore, the clinical examination must be carried out carefully to detect the origin of the patient's complaints. Several special examination techniques are available, but their application and interpretation strongly depend on the skills and experience of the physician. Most tests are not evaluated in comparison to the gold standard of wrist arthroscopy with respect to sensitivity and specificity. The most reliable test for the DRUJ are the ulnar fovea sign, the dorsopalmar stress test and the press test.