Computed tomography was used to image the distal radioulnar joint (DRUJ) for instability. Four methods were used to quantify subluxation of the DRUJ: the Mino criteria, the epicenter method, the congruency method, and a new method called the radioulnar ratio (RUR). Validity of the various methods was evaluated in clinical and laboratory situations. Rheumatoid patients with symptomatic DRUJ pathology had significantly more abnormal RUR values (100% vs 73% [epicenter method] and 88% [Mino criteria]). The RUR detected instability sooner in a progressive laboratory-induced instability model. The intraobserver and interobserver reliability of the RUR was high, with intraclass correlation coefficients of 0.89 and 0.87, respectively. The RUR demonstrated superior performance in the diagnosis of DRUJ subluxation. (J Hang Surg 2001;26A:236-243. Copyright © 2001 by the American Society for Surgery of the Hand.)
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Accepted: November 8, 2000
Received: November 23, 1999
☆No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
☆☆Reprint requests: Graham J.W. King, MD, Hand and Upper Limb Centre, St Joseph's Health Centre, 268 Grosvenor St, London, Ontario, N6A 4L6 Canada.
© 2001 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.