The hockey-stick palmar crease: a typical characteristic in CHARGE & fetal alcohol syndrome!

The ‘hockey-stick’ palmar crease is an unusual variant of the distal palmar crease – in palmistry a.k.a. the ‘heart line’. The typical characteristic concerns the widening of the crease combined with a termination between the index- and middle finger.

The ‘hockey-stick’ crease is relatively common in CHARGE, and in fetal alcohol syndrome (FAS).


A typical CHARGE hand displays a combination of the following characteristics: square hand, short fingers, finger-like thumb, and hockey-stick palmar crease.


A typical FAS hand displays a combination of the following characteristics: small thumb, short fingers, clinodactyly (curved 5th finger), camptodactyly, broad palm, and hockey-stick palmar crease.

Simian crease
Sydney line

What are today the world’s most popular websites about the controversial topic named ‘palm reading’?

In november 2010 the new palmistry ‘ranking’ formula (based on internet statistics) was presented – and the results are now available!

An analysis of 370+ websites from 6 continents indicates that the following 10 websites today can be recognized as ‘leading’ in the field of modern hand reading (including: hand analysis, chirology, palm reading, palmistry, etc).

‘Click’ on the website thumbnail(s) for direct access! 

No.1 - website presented by cheirologist Kenneth Lagerström (Canada).
No.2 - website presented by hand analyst Larry Rodrigues (US).
No.3 - website presented by chirologist Arnold Holtzman (Israel).
No.4 - website presented by fingerprint expert Andres J. Washington (US).
No.5 - website presented by hand analyst Edward D. Campbell (US).
No.6 - website presented by chirologist Jennifer Hirsch (South-Africa).
No.7 - website presented by cheirologist Galina Soroka (Russia).
No.8 - website presented by handleser Manfred Magg (Germany).
No.9 - website presented by antropologist F. van Cappelle (Netherlands).
No.10 - website presented by hand analyst Leslie Zemenek (Canada).

NOTICE: The full TOP 100 ranking is available at:


Hands event at 'Welcome Collection' (Nov 26, London)

 At November 26 the ‘Welcome Collection’ in London presents their ‘Hands’ event! How would our society look like without any hands? We sense, create and communicate with our hands. A social event for the incurably curious and celebrate these vital parts of our bodies across four floors of Wellcome Collection!!

From medicine to mesmerism, magic to mannerisms, visitors will find out about the curious history of digits, palms, fingers and thumbs, and put their own to use, as we celebrate the organs that shape the world around us. We will have scientists, artists, palmists and magicians at hand for discussions, performances and, of course, hands-on activities, all designed to make us look afresh at our body. ‘Manipulate’, ‘manoeuvre’ and ‘manufacture’ are all words deriving from the Latin word ‘manus’, meaning hand. These creative appendages allow us to make, touch and feel, but they also hold mystical and cultural significance. For one night only, visitors can explore a digital age that goes back millennia. 


• Revel in the mystery of hands with palmistry and neuroscience illusions.
• Try out some nail art.
• Get dexterous with games and computers from different ages – and paper, scissors, stone.
• Enjoy an installation produced by young people from HCA, Coram’s Fields, KCBNA and artist Elaine Duigenan.
• Try out some surgeon’s tools, and see how steady your hands are.
• Explore the wonders of handwriting in the Wellcome Library, and meet a palaeographer and a graphologist.
• Play a piano and see your digits up close.
• Enjoy the physical theatre performance of The Articulate Hand with Andrew Dawson. Performances start at 20.00 and 21.45. Tickets are available on the night of the event only.
• Hear from evolution expert Christophe Soligo on the difference between the hands of apes and humans. Tickets are available on the night of the event only.
Chris McManus will uncover the science of left and right handedness. Tickets are available on the night of the event only.

LOCATION: 183 Euston Road, London (nov 26, 19:00 – 23:00) 

It’s a FREE event, so anyone can drop in anytime!!

A discussion about more details of this ‘hands’ event is available at the Modern Hand Reading Forum.



“Get them a bottle of perfume.”

A classic story about ‘hand gestures‘ came from the formerly famous The Stork Club (1929-1965) in New York City, which became known as a famous Manhattan night club that was founded by Sherman Billingsley. The New York City hot spot — which was located on 53rd Street near Fifth Avenue — was a destination for celebrities, artists, writers and wealthy people in general. You might remember The Stork Club from an appearance in the second season of Mad Men when Don and Betty infamously attended a party hosted by Jimmy Barrett.

LIFE presents an interesting series of images of Mr. Billingsley’s body language demonstrating his own brand of nightclub-code via hand gestures [8 images].

Call me to the phone, I want to get away from this table.


“Call me to the phone, I want to get away from this table.”

Get them out & don’t let them in again.HAND SIGNAL 3:

“Get them out & don’t let them in again.”


No check for this table. I got it.HAND SIGNAL 4:

“No check for this table. I got it.”


'Not important people' or 'No need to pay attention to these folks.'HAND SIGNAL 5:

“Not important people,” or, “No need to pay attention to these folks.”


Bring a bottle of champagne.HAND SIGNAL 6:

“Bring a bottle of champagne.”


Bring a round of drinks.HAND SIGNAL 7:

“Bring a round of drinks.”


The music in the main dining room is too loud.HAND SIGNAL 8:

“The music in the main dining room is too loud.”

The hand of Mrs. Röntgen: the first X-rays photo of a human body!

Today, exacty 115 years ago, on november 8, 1895, Wilhelm Röntgen (1845-1923) made his famous discovery: he produced and detected electromagnetic radiation in a wavelength range today known as X-rays or Röntgen rays, an achievement that earned him the first Nobel Prize in Physics in 1901. The picture above is the very first röntgen photo made of a human body: it’s Mrs. Röntgen’s hand, including her wedding ring!

Wilhelm Conrad Röntgen (accidentally) discovered an image cast from his cathode ray generator, projected far beyond the possible range of the cathode rays (now known as an electron beam). Further investigation showed that the rays were generated at the point of contact of the cathode ray beam on the interior of the vacuum tube, that they were not deflected by magnetic fields, and they penetrated many kinds of matter.

A week after his discovery, Rontgen took an X-ray photograph of his wife’s hand which clearly revealed her wedding ring and her bones. The photograph electrified the general public and aroused great scientific interest in the new form of radiation. Röntgen named the new form of radiation X-radiation (X standing for “Unknown”). Hence the term X-rays (also referred as Röntgen rays, though this term is unusual outside of Germany).

The announcement of Roentgen’s discovery, illustrated with an X-ray photograph of his wife’s hand, was hailed as one of mankind’s greatest scientific accomplishments (comparable with the discoversie made by Albert Einstein & Charles Darwin), an invention that would revolutionize every aspect of human existence.


In Otto Glasser, Wilhelm Conrad Röntgen and the early history of the Roentgen rays. London, 1933. National Library of Medicine.

Into the hands of Darwin – ‘Godfather’ of the Evolution-theory
Into the hands of Albert Einstein – ‘Godfather’ of modern physics

Wilhelm Röntgen discovered the X-rays!

Shake hands with the Chinese Communist Party! – First row from left: Hu Jintao, Wu Bangguo, Wen Jiabao. Second row from left: Jia Qinglin, Li Changchun, Xi Jinping. Third row from left: Li Keqiang, He Guoqiang and Zhou Yongkang.

The photo above displays the hands of the nine men who govern 1.3 billion people: the 9 leaders of the Chinese Party of China. With Hu Jintao as the party’s major leader.

They are the nine people who marched onto the podium in the Great Hall in Beijing: the top management of a party consisting of about 78 million members at the end of 2009 which constitutes about 5.6% of the total population of mainland China. They are the so-called standing committee of the party’s political bureau.

The CPC is the world’s largest political party!

MORE DETAILS: Take a look at the high-resolution version of the hands of the 9 leader of the Communist Party of China, or take a look at the hands of other political leaders in the world.

Researchers presented earlier today new evidence that neanderthals were more competitive & promiscuous than we are today! Maybe more surprizing is the method which the researchers used to acquire their new findings: via finger length measurements!

The study, published in the Proceedings of the Royal Society B, draws upon a famous and controversial indicator of social behavior: the comparative length of the index finger and the ring finger, also known as the 2D:4D finger ratio. If the ring finger is longer than the index finger, that’s supposed to be correlated with higher prenatal exposure to androgens — resulting in a higher proclivity for aggressiveness and promiscuity.

Scientists, in collaboration with researchers at the universities of Southampton and Calgary, used finger ratios from fossilised skeletal remains of early apes and extinct hominins, as indicators of the levels of exposure species had to prenatal androgens – a group of hormones that is important in the development of masculine characteristics such as aggression and promiscuity.

It is thought that androgens, such as testosterone, affect finger length during development in the womb. High levels of the hormones increase the length of the fourth finger in comparison to the second finger, resulting in a low index to ring finger ratio (2D:4D digit ratio). Researchers analysed the fossil finger bone ratios of Neanderthals and early apes, as well as hominins, Ardipithecus ramidus and Australopithecus afarensis, to further understanding of their social behaviour.

The hand bones of an early hominid - fosile presented by Wesley Niewhoener.

The hand bones of an early hominid


The rigth hand of 'Neanderthal Qafzeh 9'.

The hand bones of a neanderthal


The team found that the fossil finger ratios of Neanderthals, and early members of the human species, were lower than most living humans, which suggests that they had been exposed to high levels of prenatal androgens. This indicates that early humans were likely to be more competitive and promiscuous than people today.

The results also suggest that early hominin, Australopithecus – dating from approximately three to four million years ago – was likely to be monogamous, whereas the earlier Ardipithecus appears to have been highly promiscuous and more similar to living great apes. The research suggests that more fossils are needed to fully understand the social behaviour of these two groups.

Dr Susanne Shultz, from the Institute of Cognitive and Evolutionary Anthropology at the University of Oxford describes:

“Social behaviours are notoriously difficult to identify in the fossil record. Developing novel approaches, such as finger ratios, can help inform the current debate surrounding the social systems of the earliest human ancestors.”

And Dr Emma Nelson, an archaeologist from the University of Liverpool, argues that comparing the finger-length ratios of extinct and present-day species is a valid technique for making an indirect assessment of our long-gone ancestors’ social behavior. She said:

“It is believed that prenatal androgens (male sex hormones) affect the genes responsible for the development of the fingers, toes and the reproductive system. We have recently shown that promiscuous primate species have low index to ring finger ratios, while monogamous species have high ratios.”

“We used this information to estimate the social behaviour of extinct apes and hominins. Although the fossil record is limited for this period, and more fossils are needed to confirm our findings, this method could prove to be an exciting new way of understanding how our social behaviour has evolved.

• Primate finger length linked with social behavior
• Human finger length & sexual orientation
• Evolution of the human hand & palmar creases

A 48-year-old man presents with a 10-day history of fever, hand pain, watery diarrhea, weight loss, anorexia, and intermittent vomiting. Two nodules are noted on both thumbs of his hands. What is the diagnosis?

Medscape Case:

The lesions depicted in the photographs are Osler’s nodes. The nodes coupled with the clinical history were suspicious for infective endocarditis (IE). Medical records were obtained while the patient was undergoing evaluation in the ED. During his recent admission for these symptoms, he was told that he had endocardial vegetations and was treated with antibiotics, but he left the hospital against medical advice. Given his recent evaluation, subjective fevers, and the physical finding of Osler’s nodes, he was admitted for treatment of IE.

The incidence of IE ranges from 2.4 to 11.9 cases per 100,000 patient years. Of these, half occur in patients between the ages of 31 to 60 years. It is much more common in patients with preexisting cardiac structural anomalies or with other risk factors, such as injection drug use, prosthetic cardiac valves, or indwelling intravenous catheters. Native-valve IE occurs in 59% to 70% of cases, whereas prosthetic valve IE occurs in 14% to 30% of the time. Infective endocarditis associated with injection drug use accounts for 11% to 16% of cases.

The clinical presentation of infective endocarditis may vary. Patients whose IE is caused by highly virulent organisms, such as S aureus, have much higher morbidity and mortality, and they typically present with high fevers and rapid cardiopulmonary collapse. This rapidly deteriorating clinical course culminating in death within a few days is often referred to as acute bacterial endocarditis. Subacute bacterial endocarditis is a more indolent disease caused by less virulent bacteria, such as Streptococcus, and patients present with fever, malaise, and other nonspecific symptoms. The clinical presentation of IE can occur along a continuum between acute and subacute clinical pictures and may have overlapping bacterial etiologies. Classic presentations are uncommon; patients with IE can present with fever, chills, weakness, dyspnea, anorexia, malaise, nausea, and vomiting. In a busy ED, these common chief complaints can be easily overlooked.

Physical examination findings of IE include Osler’s nodes, Janeway lesions, Roth spots, and infectious embolic complications. Roth spots are not specific for IE and can occur in the context of other illnesses, such as systemic lupus erythematosus; however, Osler’s nodes and Janeway lesions are highly specific for IE. Osler’s nodes are small, painful nodules that appear on the palms of the hands and soles of the feet as well as the distal phalanges. They are between 2 mm and 15 mm in diameter, occasionally have a blanched center, are usually multiple, and transiently appear and resolve at different times over a period of days. There is disagreement about the etiology of these nodes. Many sources believe that Osler’s nodes are vascular phenomena resulting from immune-complex deposition into the vascular endothelium, whereas others describe the lesions as the result of microabscesses within the dermal arterioles and the papillary dermis. In contrast to painful Osler’s nodes, Janeway lesions are painless hemorrhagic plaques that are mostly present on the palms or soles. Roth spots are oval retinal hemorrhages located near the optic disc. Infectious valvular vegetations can embolize to the brain in up to 40% of IE cases; however, central nervous system manifestations of IE are not diagnostic of the condition.

The Duke Criteria used to diagnose endocarditis may be fulfilled by the finding of 2 major criteria, 1 major and 3 minor, or 5 minor criteria. The major criteria include 2 positive blood cultures or evidence of endocardial involvement on echocardiography. Minor criteria include predisposing factors, fever, vascular phenomena, immunologic phenomena, other microbiologic evidence (not meeting major criteria), and other echocardiographic findings (not meeting major criteria).

Given the diagnostic requirements, initial diagnostic studies include blood cultures, echocardiography, electrocardiography, and chest radiography. Blood cultures should be drawn from 3 separate sites over the course of an hour to increase the likelihood of identifying the bacterial species. Antibiotic therapy for acutely ill patients should be administered promptly. Cardiac echocardiography, either by noninvasive transthoracic echocardiography or transesophageal echocardiography (TEE, which is more sensitive and specific for diagnosing IE), can aid in the diagnosis of IE and provide critical information regarding the structure and function of the affected valves. Electrocardiographic findings are often nonspecific or normal, but they can show characteristic PR interval prolongation, bundle branch block, or complete heart block when the infection affects the conduction system. Surgical intervention is usually reserved for patients with severe valvular dysfunction, which is best elucidated by TEE; however, several other indications for surgery exist. Management of these patients requires infectious disease consultation.

The mainstay of treatment of bacterial endocarditis is intravenous antibiotics. Empiric therapy should be based on the characteristics of the given patient, whether an artificial valve is or is not involved, and local resistance patterns. Ultimately, definitive therapy should be based on the results of the blood culture and sensitivity. Empiric antibiotic therapy for endocarditis is tailored to cover the organisms that are most likely to infect a given patient group. For uncomplicated IE, bacteria commonly found in the upper respiratory tract, gastrointestinal tract, and skin are likely to be the causative bacterium in patients with native-valve endocarditis acquired in the community. These include staphylococci, viridans streptococci, and Streptococcus bovis, as well as the “HACEK” organisms (Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella); therefore, for empiric therapy for uncomplicated native-valve IE, intravenous ceftriaxone or nafcillin plus gentamicin is recommended. If the incidence of methicillin-resistant S aureus (MRSA) is high, vancomycin should be used.

Complicated IE includes hospital-acquired infections, intravenous drug users, and artificial valve infections. Patients with hospital-acquired infections or intravenous drug use are more likely to have infection due to S aureus. Other common organisms for this patient population include gram-negative bacteria, such as Pseudomonas aeruginosa, group D enterococci, and fungal species (such as Candida). Patients with suspected MRSA infection, intravenous drug use, or suspected hospital-acquired infections should be empirically treated with a combination of vancomycin and gentamicin. For patients with artificial valves, the organisms are most likely to be S aureus and other coagulase-negative Staphylococcal species, enterococci, and gram-negative bacilli; therefore, these patients should be empirically treated with gentamicin, vancomycin, and rifampin. Rarely, patients with blood culture-negative endocarditis may be colonized with fastidious organisms, such as Granulicatella species, Abiotrophia species, Bartonella, Coxiella burnetii, Brucella, and Tropheryma whipplei.

Prophylaxis for patients with high-risk cardiac conditions (such as prosthetic heart valve or previous IE) is indicated when they are undergoing certain procedures. Amoxicillin or ampicillin is indicated for nonpenicillin-allergic patients 1 hour before the procedure. For penicillin-allergic patients, premedication with clarithromycin, azithromycin, clindamycin, cephalexin, cefazolin, or ceftriaxone is appropriate. Antibiotic or practice guideline references should be consulted before recommending prophylaxis.

The patient in this case was admitted and underwent TEE that confirmed the presence of 2 distinct lesions on the aortic valve suspicious for vegetations. He was started on a course of intravenous antibiotics, but unfortunately, he once again left the hospital against medical advice before completion of therapy.

FINAL HINT: Consider the history of fever, weakness, and tender, painful nodules on each thumb..

DIAGNOSIS: ‘Infectious endocarditis’  (in this case: resulting from injection drug abuse!).