Distal radius x-ray

Checklist

1. Is there loss of normal anatomy (e.g. fx displacement or angulation, loss of radial height)
2. Is there involvement of the radiocarpal or distal radioulnar joint?
3. Is there discontinuity of the articular surface or diastasis (separation) of the articular fragments?
4. Are high-risk features present (severe comminution, articular step-off >2 mm, fracture-dislocation)?

Specific Views

1. PA
   1. Radial inclination (angle between line perpendicular to long axis of radius and line between radial styloid and ulnar corner of lunate fossa)
      1. Normal = 15-25 degrees
         1. Often smaller with fx
   2. Radial height (Distance between distal tip of radial styloid and articular surface of the radius)
      1. Normal ~ 10-17mm
         1. Often smaller with comminuted or impacted fx
   3. Ulnar variance (Distance between ulnar-side articular surface of radius and the ulnar carpal surface)
      1. Normally 1-2mm
2. Lateral
   1. Palmar Tilt (angle between line perpendicular to long axis of radial shaft and line through the apices of the palmar and dorsal rims of the radius
      1. Normally 10o-25o
         1. Often smaller with fx
3. Oblique
   1. May reveal intra-articular involvement not seen on other views

Source

• UpToDate