Wrist injuries are common and can lead to the development of post-traumatic osteoarthritis. For example, one major complication after a wrist fracture, is when the fractured bone heals in a mal-aligned position, called malunion. It has been assumed that a malunion after wrist fractures alters joint congruency and mechanics leading to the development of posttraumatic osteoarthritis and poor functional outcomes. It is unclear whether anatomical restoration is a key component for the management of wrist injuries and to limit the progression of post-traumatic osteoarthritis. However, the mechanistic pathways between joint structure (and mal-alignment) and patient outcomes, such as the development of osteoarthritis and joint function, are not clearly understood due to the limitations in current techniques. The present work advances our understanding of the relationship between joint structure (and mal-alignment) and joint contact mechanics using image-based 3D measurement tools. The purpose of the present work was to employ CT imaging and inter-bone distance mapping to determine the 3D implications of a wrist fracture on 3D joint space area (a measure of joint congruency). This image-based tool was then extended to 4DCT (3DCT and time) to examine the dynamic effects of wrist movement on joint contact mechanics, in the presence of a wrist injury. This research is an important step in the quest to determine a causal relationship between joint structure and patient function.