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Information

Differential Diagnosis of Musculoskeletal Disorders

Axiality: determined after limb extension at right angle to long axis of body

Metacarpal Sign!!navigator!!

= relative shortening of 4th + 5th metacarpals

√tangential line along heads of 5th + 4th metacarpals intersects 3rd metacarpal

  1. Idiopathic
  2. Pseudo- and pseudopseudohypoparathyroidism
  3. Basal cell nevus syndrome
  4. Multiple epiphyseal dysplasia
  5. Beckwith-Wiedemann syndrome
  6. Sickle cell anemia
  7. Juvenile chronic arthritis
  8. Gonadal dysgenesis: Turner + Klinefelter syndrome
  9. Ectodermal dysplasia = Cornelia de Lange syndrome
  10. Hereditary multiple exostoses
  11. Peripheral dysostosis
  12. Melorheostosis

mnemonic: Ping Pong Is Tough To Teach

  • Pseudohypoparathyroidism
  • Pseudopseudohypoparathyroidism
  • Idiopathic
  • Trauma
  • Turner syndrome
  • Trisomy 13–18

Brachydactyly!!navigator!!

= shortening / broadening of metacarpals ± phalanges

  1. Idiopathic
  2. Trauma
  3. Osteomyelitis
  4. Arthritis
  5. Turner syndrome
  6. Osteochondrodysplasia
  7. Pseudohypoparathyroidism, Pseudopseudohypoparathyroidism
  8. Mucopolysaccharidoses
  9. Cornelia de Lange syndrome
  10. Basal cell nevus syndrome
  11. Hereditary multiple exostoses

Clinodactyly!!navigator!!

= curvature of finger in mediolateral plane

  1. Normal variant
  2. Down syndrome
  3. Multiple dysplasia
  4. Trauma, arthritis, contracture

Polydactyly!!navigator!!

Frequently associated with:

  1. Carpenter syndrome
  2. Ellis-van Creveld syndrome
  3. Meckel-Gruber syndrome
  4. Polysyndactyly syndrome
  5. Short rib-polydactyly syndrome
  6. Trisomy 13

Syndactyly!!navigator!!

= osseous ± cutaneous fusion of digits

  1. Apert syndrome
  2. Carpenter syndrome
  3. Down syndrome
  4. Neurofibromatosis
  5. Poland syndrome
  6. Others

Outline