The radial styloid process is the pointed lateral projection of the distal radius, extending approximately 1.2 cm distal to the ulnar styloid, which accounts for the normal 2-3 mm of positive radial height. It provides the attachment for the radial collateral ligament of the wrist and the brachioradialis insertion.
Radial styloid fractures occur in fall-on-outstretched-hand injuries (chauffeur's fracture) and must be fixed if they involve the radiocarpal joint. Styloidectomy is performed for radial styloid impingement on the scaphoid in radial deviation, a recognised cause of radial-sided wrist pain. De Quervain tenosynovitis tenderness localises to the first extensor compartment just proximal to the styloid. Radial length is measured from the styloid tip to the distal ulna on PA wrist X-ray.
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