The Hand in Radiologic Diagnosis

There are 4 main sections of this book. The first deals with the normal hand, its development, skeletal maturation and measurement, and various special radiologic techniques. The second section describes the normal variants and congenital anomalies of the hand. Although many of the congenital anomalies alone have no clinical significance, when they are associated with other congenital anomalies they may be diagnostic of certain congenital malformation syndromes. The aim of this section is to help the reader differentiate between the normal and the abnormal, and to determine whether a certain radiologic finding is isolated or whether it is related to a malformation syndrome. To attain this goal, tables are presented, listing other findings that are associated with the variants or anomalies discussed in the text. By referring to these tables, the physician should be able to identify the conditions in which a certain finding may occur. The third section deals with congenital malformation syndromes. One chapter is an alphabetical listing of a number of syndromes which have some roentgen manifestations in the hand. Each discussion includes a brief clinical description as well as a brief summary of other radiologic findings that may be helpful in diagnosis. The references have been kept to a minimum and should be used to obtain further information about these conditions. The fourth section deals with the hand manifestations of acquired disorders. Sometimes the distinction between the acquired and the congenital is not clear. For example, several of the hematologic disorders are due to a congenital defect, as is the case for sickle cell anemia. They have nevertheless been included in the section on acquired disorders because the radiologic manifestations are mainly secondary to the hematologic disorder. A large portion of this book is devoted to the study of normal variants and congenital disorders of the hand, in particular the child's hand. This partially reflects the author's personal bias as a pediatric radiologist, and also the facts that more variations are possible in the child's hand and that the spectrum of abnormalities on the basis of congenital disorders is probably wider than that due to acquired conditions. Normal variations are also much more common in the pediatric patient. Differentiation between the various congenital malformation syndromes is often possible by means of the radiograph of the child's hand, whereas when maturation has taken place, such identification may be impossible.