Shortening of the fourth/fifth metacarpals
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Shortening of the fourth/fifth metacarpals (brachymetacarpia) and less commonlymetatarsals (brachymetatarsia) is seen in a variety of apparently disparate conditions.
Pathology
Aetiology
Common causes 2:
- idiopathic
- post-infective (e.g. osteomyelitis, yaws, tuberculosis dactylitis)
- pseudohypoparathyroidism/pseudopseudohypoparathyroidism
- post-traumatic (acute or chronic/healed and particularly those involving growth plate)
- Turner syndrome
Uncommon causes 2:
- basal cell naevus syndrome (Gorlin syndrome)
- hereditary multiple exostosis syndrome 5
- juvenile idiopathic arthritis
- sickle cell disease with secondary infarction
- homocystinuria
- Langer-Giedion syndrome
Isolated shortening of the 5th metacarpals has been recently described in a familial variant of type 1 diabetes mellitus 3.
Radiographic features
Plain radiograph
Hand x-rays readily identify the abnormality and can be assessed by drawing a line along the heads of the 4th and 5th metacarpals. If this line intersects the head of the 3rd metacarpal then shortening is deemed to be present.
Thus, shortened 4th metacarpal is the key to this finding. It is known as the metacarpal sign. It is important to note that a positive sign can be seen in up to 10% of normal individuals 4.
-<p><strong>Shortening of the fourth/fifth metacarpals (brachymetacarpia) </strong>and less commonly<strong> </strong>metatarsals (<a title="Brachymetatarsia" href="/articles/brachymetatarsia">brachymetatarsia</a>) is seen in a variety of apparently disparate conditions. </p><h4>Pathology</h4><h5>Aetiology</h5><p>Common causes <sup>2</sup>:</p><ul>- +<p><strong>Shortening of the fourth/fifth metacarpals (brachymetacarpia) </strong>and less commonly<strong> </strong>metatarsals (<a href="/articles/brachymetatarsia">brachymetatarsia</a>) is seen in a variety of apparently disparate conditions. </p><h4>Pathology</h4><h5>Aetiology</h5><p>Common causes <sup>2</sup>:</p><ul>
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Image 15 X-ray (Frontal) ( create )
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