Radial height Radial inclination Radial tilt Ulnar variance
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distal radius radiography
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distal radius radiograph measurements radial height inclination volar tilt ulnar variance normal values
Distal radius radiographic parameters
| Parameter | X-ray view | How to measure | Normal value |
|---|---|---|---|
| Radial height | PA/AP wrist | Vertical distance between two lines perpendicular to the radial shaft: one at the radial styloid tip and the other at the ulnar corner of the distal radial articular surface | 11-12 mm (approximately 8-14 mm) |
| Radial inclination | PA/AP wrist | Angle between a line joining the radial styloid tip to the ulnar corner of the distal radius, and a line perpendicular to the radial shaft | 22-23° (about 21-25°) |
| Radial tilt or volar tilt | True lateral wrist | Angle between the distal radial articular surface and a line perpendicular to the radial shaft. The normal surface faces volarly | 11-12° volar (about 7-15°) |
| Ulnar variance | PA/AP wrist, neutral forearm rotation | Relative level of the distal ulnar head compared with the ulnar margin of the distal radial articular surface | Neutral, ±2 mm |
Terminology
- Positive ulnar variance: ulna projects more distally than the radius. It commonly occurs with radial shortening after a distal radius fracture.
- Negative ulnar variance: ulna lies more proximally than the radius.
- Dorsal tilt means loss or reversal of normal volar tilt, typical of a Colles-type distal radius fracture.
High-yield memory aid: 11-11-22
- Radial height: 11 mm
- Volar tilt: 11°
- Radial inclination: 22°
For a distal radius fracture, commonly used acceptable alignment targets include radial shortening less than 3-5 mm, dorsal tilt less than 10°, and intra-articular step-off less than 2 mm. Normal ranges and reduction thresholds vary somewhat with patient age, baseline contralateral anatomy, and treatment context. Campbell's Operative Orthopaedics, 15th ed., reports averages of 22-23° inclination, 11-12 mm height, 11-12° volar tilt, and ulnar variance of ±2 mm.
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