title: Anatomic Landmarks of the Distal Radioulnar Joint.
abstract: OBJECTIVE
  Using Lister's tubercle and the ulnar styloid as landmarks, accurate localization of the distal radioulnar joint can be achieved without the need for an image-guided approach.
  
  
  METHODS
  Cadaveric dissection of 16 upper extremities was performed to measure the relationships between the ulnar styloid, Lister's tubercle, and the distal radioulnar joint. In each specimen, the location of the distal radioulnar joint (point A) in relation to Lister's tubercle and the ulnar styloid was determined as follows: (1) the perpendicular distance between the distal radioulnar joint and ulnar styloid-Lister's tubercle was measured; (2) with A' marking the intersection of this distance and the ulnar styloid-Lister's tubercle line, the location of the distal radioulnar joint along the ulnar styloid-Lister's tubercle axis was determined by comparing ulnar styloid-A' and A'-Lister's tubercle with ulnar styloid-Lister's tubercle.
  
  
  RESULTS
  The mean distance between ulnar styloid-Lister's tubercle was 4.3 ± 0.4 cm. The mean perpendicular distance between the distal radioulnar joint and the ulnar styloid-Lister's tubercle line was 0.2 ± 0.1 cm proximal to the ulnar styloid-Lister's tubercle line. The ratio of ulnar styloid-A' and A'-Lister's tubercle to ulnar styloid-Lister's tubercle was 0.5 ± 0.03 and 0.5 ± 0.03, respectively.
  
  
  CONCLUSIONS
  Simple relationships between the ulnar styloid and Lister's tubercle serve as reliable landmarks for locating the distal radioulnar joint. The distal radioulnar joint is centered about the midpoint of the ulnar styloid-Lister's tubercle axis and slightly proximal to it. This may improve the accuracy and efficacy of corticosteroid injections in the treatment of distal radioulnar joint arthritis without the need for image guidance.
authors: Division of Plastic Surgery, University of Louisville, Louisville, Ky.
authors: J
authors: J
authors: Choo
authors: Hunstad/Kortesis, Huntersville, NC.
authors: A
authors: A
authors: Augenstein
authors: Department of Radiology, University of Virginia, Charlottesville.
authors: M
authors: M
authors: Nadar
authors: University of Louisville Medical School, Louisville, Ky.
authors: E
authors: E
authors: Afflick
authors: Department of Surgery, Veterans Affairs Hospital, Louisville, Ky.
authors: M
authors: M
authors: Kasdan
authors: Division of Plastic Surgery, University of Louisville, Louisville, Ky.
authors: B
authors: B
authors: Wilhelmi
keywords: distal radioulnar joint; palpation-guided joint injection; rheumatoid arthritis; steroid joint injection; ulnar-sided wrist pain