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Anterior view. | Width = | Image2 = Gray336.png | Caption2 = Vertical section through the [[wrist#Articulations|articulations at the wrist]], showing the synovial cavities | Precursor = | System = | Artery = | Vein = | Nerve = | Lymph = }} The '''distal radioulnar articulation<ref name=":02">{{Cite book |last=Gray |first=Henry |url=https://archive.org/details/anatomyofhumanbo1918gray/page/325/mode/2up?view=theater |title=Gray's Anatomy |year=1918 |edition=20th |page=326}}</ref>''' (also known as the distal radioulnar joint,<ref>{{cite journal|author=Dyan V. Flores |author2=Darwin Fernández Umpire |author3=Kawan S. Rakhra |author4=Zaid Jibri |author5=Gonzalo A. Serrano Belmar |journal= Radiographics|title=Distal Radioulnar Joint: Normal Anatomy, Imaging of Common Disorders, and Injury Classification|date=18 Nov 2022|volume=43 |issue= 1|pages= e220109|url=https://pubs.rsna.org/doi/10.1148/rg.220109|doi=10.1148/rg.220109|pmid=36399415 |s2cid=253627145 }}</ref> or inferior radioulnar joint<ref name=":02" /><ref name=":0" />) is a [[Synovial joint|synovial]] [[pivot joint]] between the two bones in the [[forearm]]; the [[Radius (bone)|radius]] and [[ulna]]. It is one of two joints between the radius and ulna, the other being the [[proximal radioulnar articulation]]. The joint features an [[Articular disk|articular disc]], and is reinforced by the [[Palmar radioulnar ligament|palmar]] and [[Dorsal radioulnar ligament|dorsal radioulnar]] [[ligament]]s.'''<ref name=":02" />'''<ref name=":0">{{Cite book |title=Last's anatomy: regional and applied. |date=2011 |author=Chummy S. Sinnatamby |isbn=978-0-7020-4839-5 |edition=12th |location=Edinburgh |publisher=Elsevier |page=72 |oclc=764565702}}</ref> == Structure == The distal radioulnar articulation is formed by the [[head of ulna]], and the [[ulnar notch]] of the distal [[lower extremity of radius|radius]].<ref name=":0" />'''<ref name=":02" />''' === Articular disc === The joint features a triangular [[articular disk|articular disc]] that is attached to the inferior margin of the ulnar notch by its base, and to a fossa at the base of the [[styloid process of the ulna]] by its apex.<ref name=":0" /> The articular disc acts to firmly bind the distal extremities of the two bones together.'''<ref name=":02" />''' === Ligaments === The articulation is reinforced by the [[palmar radioulnar ligament]], and [[dorsal radioulnar ligament]].'''<ref name=":02" />''' ==Function== The function of the radioulnar joint is to lift and maneuver weight load from the distal radioulnar joint to be distributed across the forearm's [[Radius (bone)|radius]] and [[ulna]] as a [[load-bearing joint]].<ref>{{cite journal | doi=10.1308/003588413X13511609957452 | title=Functional anatomy of the distal radioulnar joint in health and disease | date=2013 | last1=Lees | first1=VC | journal=The Annals of the Royal College of Surgeons of England | volume=95 | issue=3 | pages=163–170 | pmid=23827285 | pmc=4165238 }}</ref> [[Supination]] of the radioulnar joint can move from 0 [[Range of motion|degrees]] neutral to approximately 80-90 degrees where [[pronation]] of the radioulnar joint can move from 0 degrees neutral to approximately 70-90 degrees.<ref>{{cite journal | doi=10.4103/0019-5413.101031 | doi-access=free | title=Distal radioulnar joint injuries | date=2012 | last1=Thomas | first1=Binu P. | last2=Sreekanth | first2=Raveendran | journal=Indian Journal of Orthopaedics | volume=46 | issue=5 | pages=493–504 | pmc=3491781 }}</ref> Supination (palms facing up) vs. pronation (palms facing down). Muscles that contribute to function are all supinator ([[Biceps Brachii|biceps brachii]], [[brachioradialis]], and [[supinator]]) and pronator muscles ([[brachioradialis]], [[Pronator Quadratus|pronator quadratus]], and [[Pronator Teres|pronator peres]]). ==Clinical significance== Injuries to the distal radioulnar articulation often result from falls onto an outstretched hand. Injury can occur with concurrent fracture of the distal radius, the ulna, or can be isolated. For the upper limit of the distal radioulnar distance, sources vary between 2&nbsp;mm<ref>{{cite journal |url=https://emedicine.medscape.com/article/398406-overview#a2 |url-access=registration |title=Distal Radial Fracture Imaging|author=Jack A Porrino Jr |editor=Felix S Chew|website=[[Medscape]]|date=15 March 2022 }} Updated: Aug 14, 2018</ref> and 5&nbsp;mm.<ref>[https://books.google.com/books?id=b7-kkx-8eqYC&pg=PA341 Page 341] in: {{cite book|title=Hand Surgery, Volumes 1-2|author=Richard A. Berger, Arnold-Peter C. Weiss|publisher=Lippincott Williams & Wilkins|year=2004|isbn=978-0-7817-2874-4}}</ref> A classification system has been proposed by [[Estaminet]] and colleagues.<ref>Estaminet et al. Estaminet-Klassifikation von distal radioulnar Aussprache-Trauma. 20. Jahresversammlung der europäischen Orthopädischen Forschungsgesellschaft (EORS 2012), am 26–28 September, Amsterdam, Die Niederlande</ref> ===Estaminet Classification=== Estaminet classified injuries of the distal radioulnar articulation into four categories with two subclasses: purely ligamentous (subclass A) and those with associated boney injury (subclass B). * [[Estaminet I]] - Attenuation on [[Magnetic resonance imaging|MRI]] only * [[Estaminet II]] - Volar distal radioulnar ligament is involved. Unstable in [[supination]]. Fixation should be in [[Anatomical terms of motion|pronation]]. * [[Estaminet III]] - Dorsal distal radioulnar ligament is involved. Unstable in pronation. Fixation should be in supination. * [[Estaminet IV]] - Both ligaments are involved. Unstable in both supination and pronation. Fixation is in neutral. ==Additional images== <gallery> Image:RightHumanPosteriorDistalRadiusUlnaCarpals.jpg|[[lower extremity of radius|Distal ends of radius]] [[lower extremity of ulna|and ulna]] along with the [[Carpal bones|bones of the wrist]] [[metacarpus|and hand]] Image:Gray421.png|Transverse section across [[lower extremity of radius|distal ends of radius]] [[lower extremity of ulna|and ulna]]. </gallery> ==See also== * [[Proximal radioulnar articulation]] ==References== {{Reflist}} ==External links== * [https://www.dartmouth.edu/~humananatomy/part_2/chapter_11.html Dartmouth Anatomy] {{Joints of upper limbs}} {{Portal bar|Anatomy}} {{Authority control}} [[Category:Upper limb anatomy]] [[Category:Joints]] </textarea><div class="templatesUsed"><div class="mw-templatesUsedExplanation"><p><span id="templatesused">Pages transcluded onto the current version of this page<span class="posteditwindowhelplinks"> (<a href="/wiki/Help:Transclusion" 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