Distal radius fracture + Distal radio-ulnar joint congruent

Distal radius fracture + Distal radio-ulnar joint disrupted (Galeazzi type)

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DRUJ assessment:

Clinical: Prominent ulnar styloid on the dorsum of the wrist (compare to contralateral side). Can be transiently reduced with manual pressure (piano key sign). Painful pro/supination.

Imaging: Distal ulna does not overlap or point in the same trajectory as the distal radius. DRUJ widening on AP XR. Compared to uninjured side, there is >50% translation of ulna relative to radius on lateral XR.

Where in doubt, fine-slice CT can confirm DRUJ status. MRI is preferred when other significant soft tissue injuries suspected, e.g. TFCC injury.

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