Mental retardation, postaxial polydactyly, phalangeal hypoplasia, 2-3 toe syndactyly, unusual face, uncombable hair: new syndrome?

We report on a boy with unique somatic and skeletal manifestations. The syndrome consists of mental retardation, postaxial polydactyly, phalangeal hypoplasia, 2-3 toe syndactyly, abnormal face and uncombable hair. A younger sib who died soon after the birth was probably also affected.

Osteoglophonic dysplasia: appearance and progression of multiple nonossifying fibromata

The appearance and gradual enlargement of fibrous cortical defects and multiple nonossifying fibromata are documented in this report of a 2-year-old boy with a very rare skeletal dysplasia known as osteoglophonic dysplasia, characterized by multiple and recurrent craniosynostoses, platyspondyly, short tubular bones, and epiphyseal dysplasia.

Dysosteosclerosis

A 5 1/2 year old boy presented with delayed development and loss of vision. A skeletal survey showed osteosclerosis consistent with dysosteosclerosis. Some unusual features of dysosteosclerosis are discussed.

Stress fractures of the fibula in the first few years of life (report of six cases)

Fibular stress fractures in children in the first few years of life are not well known and are often confused with osteomyelitis or malignant bone tumour. This misdiagnosis is followed by nuclear scan, computerized tomography (CT), magnetic resonance (MR) imaging and even biopsy. All these investigations are unnecessary as plain X-rays show diagnostic radiographic findings and misdiagnosis is highly unlikely when they are evaluated in the context of clinical findings.

Stüve-Wiedemann dysplasia in a 3 1/2-year-old boy

Stüve-Wiedemann osteochondrodysplasia is a rare disorder with distinct clinical and diagnostic radiographic findings. The condition is classified as a bent-bone dysplasia with early, lethal outcome. We report on a boy with Stüve-Wiedemann syndrome who is well and alive at the age of 3 1/2 years.

Lethal kyphomelic dysplasia

A lethal form of kyphomelic dysplasia with severe bowing of the long bones of the lower extremities is reported.

Mental retardation - megaepiphyses - ulnar pseudoepiphyses - hypoplastic fibulae - brachymesophalangia: a new syndrome

The distinctive radiographic features - megaepiphyses, hypoplastic fibulae, ulnar pseudoepiphyses and brachymesophalangy - in a 14-year-old Japanese boy with mental retardation are reported.

Case report: neonatal platyspondylic dwarfism--a new form

A new type of neonatal bone dysplasia is reported. Unusual radiographic abnormalities (platyspondyly with unique shape of the vertebral bodies, shortening of the long tubular bones without signs of rickets or metaphyseal dysplasia, marked shortening of well-ossified short tubular bones, schneckenbecken-like pelvis with tri-radiate acetabulum, pseudoepiphysis of the right ulna, unusual shape of calcaneus and periarticular calcifications) allow designation of this disorder as a new form of neonatal dwarfism.

Dutch variant of Bellini metaphyseal dysplasia: report of two siblings

Two sibling girls with cone-shaped knee epiphyses and metaphyses are described. Bone dysplasia with this rare, distinctive, radiographic finding, was first reported by Bellini and Bardare with only few cases reported thereafter. Velores et al. divided bone dysplasias with cone-shaped epiphyses and metaphyses of the knee in two entities which they named trichoscyphodysplasia and metaphyseal acroscyphodysplasia. Although the authors agree that there is more than one bone dysplasia that presents with these distinctive radiographic knee appearances, they consider that two few cases have been reported to satisfactorily classify this group of disorders.

Swollen ischiopubic synchondrosis: a dilemma for the radiologist

Differences in size and shape of ischiopubic synchondrosis in childhood may present problems in diagnosis and differential diagnosis. Whereas asymptomatic swollen ischiopubic synchondrosis represents a normal ossification process, painful swelling is a symptom of underlying pathology. Five children are described with symptomatic ischiopubic synchondrosis swelling, four representing stress reaction and one with osteomyelitis. Radiologists should be careful when reporting on swollen ischiopubic synchondrosis in symptomatic children.

Small patella syndrome

We report on 2 sporadic cases of small patella syndrome (coxo-podo-patellaire syndrome) most probably representing new mutations. Both children showed retarded patellar bone age (small patellae in Patient 1 and absent patellae in Patient 2) and pelvic abnormalities. Patient 1 who was fully investigated had an unusual facies with characteristic morphological abnormalities of the forefoot and generalized bone changes. Patient 2 was not available for examination and only X-ray films of his knees, pelvis, and chest were available. These were all abnormal. He was said to have an "unusual facies" with flattened nose and prominent forehead but no further information was available. We think that small patella syndrome (coxo-podo-patellaire syndrome) is a generalized bone dysplasia with morphological and diagnostic radiographic appearances.

Metachondromatosis

OBJECTIVES

To draw attention to metachondromatosis, which may be misdiagnosed as multiple osteochondromatosis, and to point out several findings that have not been emphasized in previous reports.

PATIENTS AND METHOD

The authors reviewed the relevant clinical and detailed radiographic findings for five patients from different countries, who underwent imaging at various ages during childhood.

RESULTS

Deformities resembling exostoses and punctate calcification were distinctive and represent previously unemphasized features of vertebral involvement in metachondromatosis. Widespread metaphyseal changes were best seen in the femoral necks, which were broad and showed prominent cartilage columns in all of the patients. Flattening of the femoral heads was observed in three patients; in one of these the flattening progressed to epiphyseal necrosis and coxa magna. In one patient the hands and feet showed no enchondromatous involvement.

CONCLUSION

Metachondromatosis is a generalized bone dysplasia predominantly affecting the tubular bones and, to a lesser degree, flat bones and the vertebral column. Significant complications may include avascular necrosis of the femoral head and progressive deformity of the small joints due to expanding local exostoses. The typical involvement of the hands and the feet may not always be seen.

Spondylo-epimetaphyseal dysplasia with joint laxity and severe kyphoscoliosis in an Italian girl

A case of spondylo-epimetaphyseal dysplasia with joint laxity (SEMDJL) in an Italian girl is reported. This condition is mainly observed in the Afrikaans population of South Africa with an ancestral founder believed to be localized in West Germany. This case might support a link with the European origin of SEMDJL.

A new form of rhizo-mesomelic bone dysplasia

A new form of rhizo-mesomelic dwarfism in an 8 1/2-year-old gypsy Slovakian girl is reported. This patient shows some superficial similarity to patients with Robinow syndrome. However, different facies, normal external genitalia and absence of radiographic abnormalities characteristic of Robinow syndrome (malsegmentation of the spine and ribs, short, small tubular bones and bifid terminal phalanges) as well as mesomelic hypoplastic/dysplastic changes in the forearm bones allow us to separate this disorder as a distinctive entity.

Case report 870. Schneckenbecken dysplasia, possibly a new variant

We report the case of a newborn with a lethal newborn skeletal dysplasia, in whom skeletal and morphologic findings resembled those in schneckenbecken dysplasia except that the projection of bone from the medial aspect of the iliac bones, resembling the "snail's" head, was absent. This could be accounted for by variability or genetic heterogeneity.

Hajdu-Cheney syndrome in a 3 1/2 year old girl

Hajdu-Cheney acro-osteolysis is reported in a 3 1/2 year old girl whose mother has the syndrome. Acro-osteolysis was shown to be absent at the age of 2 1/2 years. It was demonstrated on hand X-rays performed a year later. This is the youngest case of Hajdu-Cheney acro-osteolysis reported in the literature.

Desbuquois syndrome complicated by obstructive sleep apnoea and cervical kyphosis

We present two children with Desbuquois syndrome and characteristic facial appearance, and musculoskeletal and radiological findings. Two new complications of this syndrome are obstructive sleep apnea and severe cervical kyphosis.

Free radical adducts induce alterations in DNA cytosine methylation

Methylation of cytosines in DNA is important for the regulation of expression of many genes. During carcinogenesis, normal patterns of gene methylation can be altered. Oxygen radical injury, shown to damage DNA in a variety of ways associated with cancer development and other conditions, has been suggested to affect DNA methylation, but a mechanism has not been demonstrated. Using oligonucleotides containing the common oxygen radical adduct 8-hydroxyguanine to replace guanine, we found that the enzymatic methylation of adjacent cytosines is profoundly altered. Furthermore, there is a high degree of positional specificity with respect to this effect. Thus, free radical injury may explain some of the altered methylation observed during carcinogenesis.

Osteomesopycnosis

The radiographic findings in two children with osteomesopycnosis are described. This is the first report in the Australian literature of this uncommon, recently described entity.