Wrist (Forearm Rotating Joint) Arthritis
Distal RadioUlnar Joint
Recognising the Symptoms and Symptoms
Ali Phillips | Hand & Wrist Specialist
Pain when you grip and twist?
I'm Ali Phillips. If pain on the little finger side of your wrist makes it difficult to turn a doorknob or open a jar, you might have DRUJ arthritis. Let's explore what this is and how we can restore your wrist's function and comfort.
Book a ConsultationWhat is DRUJ Arthritis?
The Distal Radioulnar Joint (DRUJ) is the joint on the little finger side of your wrist where your two forearm bones, the radius and ulna, meet. This joint is essential for rotating your forearm, allowing you to turn your palm up and down.
DRUJ arthritis is the wearing away of the cartilage in this specific joint. As the cartilage thins, the bones rub against each other, causing pain almost exclusively when you grip objects tightly and twist your forearm.
What are the symptoms of DRUJ Arthritis?
Pain with Twisting
The main symptom is pain on the little finger side of your wrist, especially when turning a key, opening a jar, or using a screwdriver.
Weak Grip
You might notice that your grip feels weak, and you may lose confidence when lifting heavy objects like a kettle or pan.
Clicking or Popping
A clicking or popping sound or sensation may occur when you rotate your forearm.
Is Twisting Your Wrist Painful?
If these symptoms are making daily tasks a challenge, a clear diagnosis is the first step towards a solution. Let's find out what's going on and create a plan to help.
Get a Clear DiagnosisHow will I diagnose your wrist pain?
Diagnosis involves a careful examination, a discussion of your symptoms, and an X-ray. A key test is to check for pain when the DRUJ is squeezed. You can try a gentle version at home, but stop if it causes significant pain.
1️⃣
Rest your affected forearm on a table, palm facing down.
2️⃣
With your other hand, gently squeeze the two bones on either side of your wrist.
3️⃣
Note if this squeezing action reproduces your pain.
Pain with this "squeeze test" is a strong indicator of DRUJ arthritis. To be absolutely certain, I will often perform an injection of local anaesthetic and steroid directly into the joint. If the pain disappears, it confirms the diagnosis and also provides you with some immediate relief.
How can I help you get better?
We'll create a personalised treatment plan together, starting with the simplest options first.
Hand Therapy & Splinting A specialist hand therapist can provide a bespoke thermoplastic splint to prevent painful rotation, along with targeted exercises.
Injections A steroid injection can provide excellent temporary relief and confirms the diagnosis.
Ulnar Head Replacement If the joint is stable, surgically replacing the head of the ulna bone can provide lasting pain relief while preserving rotation.
Scheker DRUJ Replacement For unstable joints, a total joint replacement like the Scheker implant is an excellent, reliable option to restore stability and eliminate pain.
Frequently Asked Questions
It's most often caused by "wear-and-tear" (osteoarthritis) over time. It can also develop after a wrist injury, like a fracture, or be associated with inflammatory conditions like rheumatoid arthritis.
Yes, the symptoms can be very similar to a tear of the Triangular Fibrocartilage Complex (TFCC), a key stabilising structure in the wrist. The "squeeze test" is helpful, as squeezing the joint often causes more pain with arthritis but can relieve it with a TFCC tear. A diagnostic injection is the best way to be certain.
Surgery is always the last resort. We would only consider it if non-surgical treatments like bespoke splinting and injections have failed to provide enough relief, and the pain is significantly impacting your daily life and ability to grip and twist.
An ulnar head replacement is a partial replacement, where only the end of the ulna bone is replaced. It's an excellent option if the joint is stable. The Scheker is a total DRUJ replacement, replacing both sides of the joint. It's used when the joint is unstable, as it provides the necessary stability to restore function.
Recovery involves a period of immobilisation in a cast or splint, followed by dedicated hand therapy to restore rotation and strength. While you can return to light activities relatively quickly, a full return to heavy or forceful tasks can take several months.
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