30 August 2013

Can you see what's wrong with the bones in this person's hand?


Answer below the fold, via Electric Orchids.
He has too many of them.  See also Polydactyly in the paintings of Raphael.

17 comments:

  1. Well there seems to be an extra finger. What do I win?

    It is a pretty normal looking finger though, which is unusual.

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  2. Oddly enough, it's a dominant trait in humans.

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  3. Any idea how old the person is? I'm not a radiologist, and it's been a long time since I've looked at pediatric films. Admittedly, the extra digit is not what jumped out at me, especially given the way that the question was phrased.

    Each bone appears to still have a prominent growth plate. Either this is a child (my assumption), or there is something developmentally wrong with the hand beyond just the extra digit. I'm assuming it's the former, but I'm so used to seeing adult hand x-rays that this just looks strange to me (stranger than an extra finger!)

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    1. Definitely a child. The distal epiphyses of the metatarsals are still separate from their diaphyses or just barely attached (depending on the digit). The carpals look fully formed, though. A quick Google Image search makes it look like a belongs to someone between 8 and 13, giving some error for delayed or accelerated growth.

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    2. The unfused growth plates is what caught my eye...didn't notice the extra digit

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  4. My name is Inigo Montoya...

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    1. Inigo Montoya had the normal number of digits. Count Rogan was the six-fingered man.

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    2. Score one for the Dragonmamma.

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  5. So far, no correct answer to the question.
    I know little about bones, and I'm no radiologist.
    But the question asks if we can see what's wrong with the bones, not if we can see there's an extra finger, which may be unusual, but could have perfect bones.

    I'd say the little finger on the far right appears to have a strangely truncated penultimate bone, with no associated plate.

    Injury?

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  6. looks the problem is... a sixth digit! Is that a problem, though?

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  7. Has there ever been a piano piece composed for polydactyl players?

    Lurker111

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    Replies
    1. Try this instead -

      http://tywkiwdbi.blogspot.com/2008/07/rachmaninoff-had-big-hands.html

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  8. Well... I am a radiologist and everyone here is spot on. 6th digit is rare. Patient is between 10 and 14 years old.
    The abnormalities:
    - extra digit metacarpal has an extra physis, usually a rare variant in the 1st digit metacarpal (thumb), but I've never seen it in a 2nd - 5th digit.
    - early closure of the physis in extra digit middle phalanx. common in the toes. I've never seen it in the hand without prior trauma.
    - hamate is oddly shaped. in order to articulate with the extra digit, 3 total instead of 2.

    pretty cool.

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  9. Thanks for the expert input!

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  10. the 1990s film Gattaca has principals Uma Thurman and Ethan Hawke attend a concert, where it is revealed that the pianist has extra digits. the piece is commented to be only playable by such polydactyl players. the larger theme of Gattaca is about the impact of breeding for superiority.

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