![]() ![]() Almost everyone in the crowd has their arm out, thumb pointed down to the ground. His famous painting “Pollice Verso” depicts a crowded arena looking down on a few gladiators, only one of whom is still standing, foot pressed to the throat of one of his fallen combatants. Then, in 1872 the popular and influential painter Jean-Léon Gérôme, well, turned things upside-down a bit. From the 1600s until the early 1900s, that’s the primary dichotomy of thumbs: bent up (death) or down (life). The thumb turned, extending from the hand, was translated from Latin as a sign of “disapprobation” in a number of instances that the Oxford English Dictionary records. In the intervening years, the thumbs-up gesture was mostly mentioned in reference to the Latin. So how did the meaning get swapped around? In antiquity, says Corbeill, “the thumb was hostile in the same way the middle finger was hostile, and it was a threat, just like it is now.” There’s a poem that describes a crowd gesturing towards a gladiator with an unfriendly or hostile thumb, and then the same phrase is used in other contexts where it clearly means the upturned thumb. “‘Turning the thumb’ is turning the thumb up ,” he says, “and you’ve got the ‘up’ gesture.”Īnother reason we know the thumbs-up was the kill signal was a gesture known as the infestus pollex or hostile thumb, which is mentioned in texts but, again, isn’t pictured. He’s got a fist with his thumb pressing down on it.”įor example, the word for turning also means turning a limb in question on the joint, but doing the modern thumbs-down gesture involves turning the wrist, not the thumb. “And right underneath, one of the referees is pressing his thumb. There’s two referees around them breaking up the battle and up above it says, in Latin, STANTES MISSI, which means ‘let the men who are still standing be released,'” he says. “What’s great about these is that they often have text accompanying them, so what you see very clearly is two gladiators fighting to a standstill. “A thumb can press or be pressed, it works both ways.”Ĭorbeill located an example of what exactly the gesture might look in Nîmes, in southern France, when he found an appliqué medallion that shows a scene from a gladiatorial battle. “The verb premere in latin is just as ambiguous as ‘press’ in English,” he says. The Latin term for the gesture of approval, Corbeill explains, is pollices premere, which means “press your thumbs” and has been described by Pliny the Elder as a common gesture of good wishes. ![]() Injection Thumbs-up sign Trapeziometacarpal joint.Historical confusion about that thumb-pressing gesture exposes just how difficult it can be to track the evolution of body language. The "Thumbs-up" sign is an inexpensive indicator of successful intra-articular injection and may obviate the need and expense of advanced imaging modalities at the time of injection. Patient relaxation and joint compliance are limiting factors. The "Thumbs-up" sign is a practical clinical tool that gives the practitioner important visual feedback at the time of injection. Eighteen of twenty-seven thumbs had sustained relief at 3 months post injection. The thumbs-up sign demonstrated a 92.3 % sensitivity. There were three negative "Thumbs-Up" injections. Twenty-four of twenty-seven injections demonstrated a positive "Thumbs-up" sign. Visual analog pain scale scores were obtained pre-injection and by follow-up telephone calls at 1 week, 6 weeks, and 3 months post injection. At the time of injection, the presence or absence of the "Thumbs-up" sign was noted, and needle location was verified after injection with orthogonal mini-C arm fluoroscopic images. Trapeziometacarpal joint injections were performed on twenty-seven thumbs utilizing anatomic landmarks. The purpose of this study is to investigate the occurrence of the "Thumbs-up" sign with injection of the thumb trapeziometacarpal joint as a useful and reliable clinical indicator of intra-articular trapeziometacarpal injection and correlate level and duration of pain relief. The changes of limb position that occur at the time of intra-articular injection can provide valuable visual and tactile feedback to the clinician. Some studies utilize anatomical landmarks for proper injection placement while others utilize modalities including ultrasound and fluoroscopy. Several clinical studies investigating the accuracy and efficacy of trapeziometacarpal injection exist. ![]()
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