Short 4th metacarpal: post-traumatic
Pain post fall ?fracture.
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No acute fracture or malalignment. Short fourth metacarpal noted on frontal view, seen to be post-traumatic (healed fracture) on the oblique view.
There is a long list for causes/associations of a short fourth (or fifth metacarpal). Post-traumatic is a common cause that shouldn't be forgotten - "when you hear hooves, look for horses not zebras".