title: The pattern of skeletal anomalies in the cervical spine, hands and feet in patients with Saethre-Chotzen syndrome and Muenke-type mutation.
abstract: BACKGROUND
  Saethre-Chotzen syndrome (SCS) and Muenke-type mutation (MTM) are complex syndromes with craniosynostosis and skeletal anomalies including syndactyly, carpal and tarsal fusions, and cervical spine abnormalities.
  
  
  OBJECTIVE
  In this study, we analysed radiographs of the cervical spine, hands and feet of a large patient population with genetically proven SCS and MTM. The aim was to describe the pattern of skeletal anomalies and to determine whether specific features are present that could help differentiate between the two entities.
  
  
  METHODS
  Radiographs of 43 patients (23 males, 20 females) with SCS (n=35) or MTM (n=8) were evaluated. The median age was 8 years (range 1 month-36 years). All radiographs were reviewed by two radiologists.
  
  
  RESULTS
  In the hands and feet, a variety of anomalies such as brachyphalangy, clinodactyly, partial syndactyly, partial carpal or tarsal fusion, and cone-shaped epiphyses were noted. Duplicated distal phalanx of the hallux (n=12/35) and triangular deformity of the epiphysis of the distal phalanx of the hallux (n=10/35) were detected in SCS only; calcaneo-cuboid fusion (n=2/35) was detected in MTM only. In the cervical spine, fusion of vertebral bodies and/or the posterior elements occurred only in patients with SCS.
  
  
  CONCLUSIONS
  Pathognomonic signs for SCS are the triangular shape of the epiphysis and duplicated distal phalanx of the hallux. Calcaneo-cuboid fusion was detected in MTM only. These signs may be helpful in the differentiation of SCS from MTM.
authors.affiliation: Department of Paediatric Radiology, Institute of Radiodiagnostics, University of Würzburg, Josef-Schneider-Str. 2, Germany. trusen_a@klinik.uni-wuerzburg.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Trusen
authors.forename: Matthias
authors.initials: M
authors.lastname: Beissert
authors.forename: Hartmut
authors.initials: H
authors.lastname: Collmann
authors.forename: Kassa
authors.initials: K
authors.lastname: Darge
mesh_terms: D000168:Acrocephalosyndactylia / Q000000981:diagnostic imaging* / Q000235:genetics*; D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D005532:Foot Deformities, Congenital / Q000000981:diagnostic imaging*; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D009154:Mutation; D011859:Radiography; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013131:Spine / Q000002:abnormalities / Q000000981:diagnostic imaging