Interphalangeal Joint Dislocation of the Fingers and Toes Workup

Updated: Dec 04, 2019
  • Author: Grace M Young, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Workup

Imaging Studies

Take anteroposterior, true lateral, and oblique radiographs of the affected digit. Obtain 3 views prior to and after reduction (see the images below). [17]

Anteroposterior view of distal interphalangeal (DI Anteroposterior view of distal interphalangeal (DIP) joint dislocation
Lateral view of distal interphalangeal (DIP) joint Lateral view of distal interphalangeal (DIP) joint dislocation
Oblique view of distal interphalangeal (DIP) joint Oblique view of distal interphalangeal (DIP) joint dislocation
Oblique view of proximal interphalangeal (PIP) joi Oblique view of proximal interphalangeal (PIP) joint dislocation

Physeal, avulsion, or distal tuft fractures, as well as osteochondral fragments, are often subtle and seen only on 1 or 2 views.

Obtain stress views to assess joint stability.

Features to note on radiographs include the following [18] :

  • Percentage of articular surface involvement

  • Articular step or gap

  • Comminution or fragmentation

  • Number of fracture fragments

  • Joint subluxation or dislocation

When there is joint subluxation, a V sign is seen, which describes an asymmetric joint space seen on a true lateral radiograph.