The middle phalanx of the left hand is fragmented, but well corticated, with no evidence of an acute fracture. This impression was confirmed on the X-ray of both hands; the appearance is similar in the uninjured right hand. This is an unusual appearance of clinodactyly, a curvature of the finger in the mediolateral plane, sometimes a normal variant, as in this case, but also associated with Down's syndrome and multiple dysplasia. A similar case appears in Keat's Atlas of normal variants that may simulate disease, 5th Ed, p 480).