Wrist & Hand Assessment

DRUJ Test | Distal Radioulnar Joint Test

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DRUJ Test | Distal Radioulnar Joint Test | Wrist Instability Assessment

The Distal Radioulnar Joint Test abbreviated as DRUJ Test is an orthopedic test to assess for a ligament tear of the distal radioulnar joint.

While most commonly the SL ligament and TFCC are affected in wrist ligament injuries, the wrist is a complex region and requires a thorough assessment as missed ligament injuries may result in persistent pain, instability, and reduced grip force and range of motion and could lead to early osteoarthritis. Prosser et al. in (2011) evaluated the Lunotriquetral Ballottement Test or Shuck Test on its diagnostic accuracy and report a positive likelihood ratio of 1.79 and negative likelihood ratio of 0.3 when compared with arthroscopy findings making it at most mildly useful in excluding an injury but overall the test has a weak clinical value.

To conduct the test, the patient’s forearm is held in neutral rotation and the examiner stabilizes the distal radius and hand as one unit with a firm grip.

The other hand then grasps the distal ulna and forces it into dorsal and palmar direction relative to the radius.

This procedure is repeated in relative supination and pronation.

The stability of the distal radioulnar joint is compared to the uninjured wrist and marked laxity, as well as the reproduction of the patient’s painful symptoms, indicate a positive test.

Other common tests to assess instability of the wrist:

 

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References

Prosser, R., Harvey, L., LaStayo, P., Hargreaves, I., Scougall, P., & Herbert, R. D. (2011). Provocative wrist tests and MRI are of limited diagnostic value for suspected wrist ligament injuries: a cross-sectional study. Journal of physiotherapy57(4), 247-253.

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