Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Radiocarpal Joint

The radiocarpal joint is a synovial joint of the distal wrist that is formed between the radius and the proximal row of carpal bones, the scaphoid, lunate and triquetral bones. Wrist injuries are common and occur from overuse and trauma. The radiocarpal joint is composed of the proximal concave surface of the radius and the articular disc or triangular fibrocartilage. The distal portion of this joint includes the convex row of carpal bones. Diagnostic musculoskeletal ultrasound (MSKUS) offers a portable, real-time, and cost-effective alternative that is gaining traction in rehabilitation and sports medicine settings. MSKUS has emerged as a valuable, non-invasive imaging modality for evaluating wrist ligaments, discs and bones. MSKUS is excellent at detecting changes in ligament composition and continuity. This manuscript will review the utility of MSKUS in evaluating the radiocarpal joint injury including anatomy, common mechanism of injury patterns, sonographic techniques, and clinical implications for those in the rehabilitation profession. Due to its small size, and variety of structures in a small space, diagnosis of acute radiocarpal injury by physical examination is often difficult. By integrating MSKUS into clinical practice, providers can improve the accuracy of diagnosis, enhance diagnostic confidence, monitor healing progression, and guide rehabilitation strategies to optimal patient outcomes for those with wrist injuries.