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Xray of the hand of a girl with Turner's syndrome, demonstrating the characteristic findings of short fourth metacarpal with positive metacarpal sign. Also note the Madelung deformity.
In the metacarpal sign, a line drawn along the heads of the 4th and 5th metacarpals will intersect the head of the 3rd metacarpal if shortening is present. The shortened 4th metacarpal is the key to the sign.
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