Shortening of the fourth/fifth metacarpals
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Shortening of the 4th and 5th
- idiopathic
- post-traumatic
/(acute and chronic/healed) - post-infective (e.g. osteomyelitis, yaws, tuberculosis dactylitis)
- Turner syndrome
- pseudohypoparathyroidism
- pseudopseudohypoparathyroidism
- basal cell naevus syndrome - Gorlin syndrome
- sickle cell disease with secondary infarction
- hereditary multiple exostosis syndrome 5
- homocystinuria
- Langer-Giedion syndrome
Isolated shortening of the 5th metacarpals has been recently described in a familial variant of Type I diabetes mellitus 3.
Radiographic features
Plain film
Hand x rays-rays readily identify the abnormality, and can be assessed by drawringdrawing a line along the heads of the 4th and 5th metacarpals. If this line intersect 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 9.610% of normal individuals 4.
-<p><strong>Shortening of the 4<sup>th</sup> and 5<sup>th </sup>metacarpals</strong> is seen a variety of apparently disparate conditions including : </p><ul>- +<p><strong>Shortening of the fourth/fifth metacarpals</strong> is seen a variety of apparently disparate conditions including : </p><ul>
-<li>post-traumatic / post-infective (e.g. <a href="/articles/osteomyelitis">osteomyelitis</a>, <a href="/articles/yaws">yaws</a>, <a href="/articles/tuberculosis-dactylitis">tuberculosis dactylitis</a>)</li>-<li><a title="Turner syndrome" href="/articles/turner-syndrome">Turner syndrome</a></li>- +<li>post-traumatic (acute and chronic/healed)</li>
- +<li>post-infective (e.g. <a href="/articles/osteomyelitis">osteomyelitis</a>, <a href="/articles/yaws">yaws</a>, <a href="/articles/tuberculosis-dactylitis">tuberculosis dactylitis</a>)</li>
- +<li><a href="/articles/turner-syndrome">Turner syndrome</a></li>
-</ul><p>Isolated shortening of the 5<sup>th </sup>metacarpals has been recently described in a familial variant of Type I <a href="/articles/diabetes-mellitus">diabetes mellitus</a> <sup>3</sup>.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Hand x rays readily identify the abnormality, and can be assessed by drawring a line along the heads of the 4<sup>th</sup> and 5<sup>th</sup> metacarpals. If this line intersect the head of the 3<sup>rd</sup> metacarpal then shortening is deemed to be present. </p><p>Thus, shortened 4<sup>th</sup> metacarpal is the key to this finding. It is known as the <a href="/articles/positive-metacarpal-sign">metacarpal sign</a>. It is important to note that a positive sign can be seen in up to 9.6% of normal individuals <sup>4</sup>.</p>- +</ul><p>Isolated shortening of the 5<sup>th </sup>metacarpals has been recently described in a familial variant of Type I <a href="/articles/diabetes-mellitus">diabetes mellitus</a> <sup>3</sup>.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Hand x-rays readily identify the abnormality, and can be assessed by drawing a line along the heads of the 4<sup>th</sup> and 5<sup>th</sup> metacarpals. If this line intersect the head of the 3<sup>rd</sup> metacarpal then shortening is deemed to be present. </p><p>Thus, shortened 4<sup>th</sup> metacarpal is the key to this finding. It is known as the <a href="/articles/positive-metacarpal-sign">metacarpal sign</a>. It is important to note that a positive sign can be seen in up to 10% of normal individuals <sup>4</sup>.</p>
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Case 6 -: short fourth metacarpals :4th metacarpal - Turner syndrome
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Case 2 -: positive metacarpal sign
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Case 3 -: isolated unilateral shortened 5th metacarpal
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Case 4 -: Turner syndrome
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Case 5 -: Turner syndrome - hand
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Case 7 -: short fourth metacarpal
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Case 8 -: short 4th/5th metacarpal
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Case 9-: short 5th metacarpal
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