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Thumbs down: testing anatomy in the ED
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  • Published on:
    • Santosh Bongale, Consultant in Emergency Medicine Royal Alexandra Hospital & Inverclyde Royal Hospital

    Dear Dr J Benger,

    Thank you for highlighting the need for correction in the article. The option D was meant to be spelt as Abductor pollicis longus (APL) instead of Adductor pollicis longus.  Your elaboration on the anatomy of APL muscle will help readers understand our article better.

    Conflict of Interest:
    None declared.
  • Published on:
    Thumbs down for anatomical accuracy
    • Jonathan Benger, Consultant in Emergency Medicine University Hospitals Bristol NHS Foundation Trust

    Smith and Bongale correctly emphasise the importance of anatomical accuracy when examining the hand.[1] However their article requires correction. The muscle adductor pollicis longus (answer D in their question) does not exist. The abbreviation APL usually denotes abductor pollicis longus, a muscle of the forearm which contributes to abduction and extension of the thumb, and which runs alongside extensor pollicis brevis as it crosses the anterior (radial) border of the anatomical snuffbox. Adductor pollicis (shown in Figure 2 of the article) is an intrinsic muscle of the hand, and is not involved in thumb extension.

    Hand injuries are common in Emergency Departments. Anatomical accuracy is essential when examining and describing these important presentations.

    1. Smith E, Bongale S. Thumbs down: testing anatomy in the ED. Emerg Med J 2019;36:224-238.

    Conflict of Interest:
    None declared.