title: Radial longitudinal deficiency: the incidence of associated medical and musculoskeletal conditions.
abstract: OBJECTIVE
  Radial longitudinal deficiency (RLD) is associated with certain syndromes and medical and musculoskeletal conditions. The purpose of this investigation was to evaluate the incidence of these conditions with RLD.
  
  
  METHODS
  A comprehensive chart review identified patients with RLD and a complete medical record. These charts were evaluated for the presence of associated medical and musculoskeletal conditions and biographic information on gestation, delivery, and family history.
  
  
  RESULTS
  A total of 164 patients with 245 affected extremities were identified; 138 patients had radius abnormalities and 26 patients had isolated thumb hypoplasia. Twenty-five patients had thrombocytopenia absent radius syndrome; 22 patients had vertebral, anal, cardiac, tracheoesophageal, renal, and limb abnormalities association; 7 patients had Holt-Oram syndrome; and 1 patient had Fanconi anemia. There were 32 patients with cardiac abnormalities and 60 patients with spinal or lower-extremity musculoskeletal abnormalities. The percentage of patients with associated abnormalities increased with an increasing severity of RLD. One hundred two of the 138 patients with types I through V RLD had associated medical or musculoskeletal abnormalities. In contrast, only 9 of 26 patients with an isolated thumb hypoplasia (type 0 RLD) had associated abnormalities.
  
  
  CONCLUSIONS
  The high incidence of associated medical and musculoskeletal abnormalities in patients with RLD emphasizes the importance of a complete assessment including a complete musculoskeletal examination, cardiac auscultation, complete blood count, echocardiogram, renal ultrasound, and spinal radiographs. Although approximately one third of patients in this investigation had a syndrome commonly associated with RLD, most patients with RLD types I through V had an additional medical or musculoskeletal anomaly. Patients with type 0 RLD were less likely to have comorbidities.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, MO 63110, USA. goldfarbc@wustl.edu
authors.forename: Charles A
authors.initials: CA
authors.lastname: Goldfarb
authors.forename: Lindley
authors.initials: L
authors.lastname: Wall
authors.forename: Paul R
authors.initials: PR
authors.lastname: Manske
mesh_terms: D000013:Congenital Abnormalities / Q000145:classification / Q000453:epidemiology / Q000235:genetics; D005199:Fanconi Anemia / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008923:Missouri / Q000453:epidemiology; D011884:Radius / Q000002:abnormalities*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013577:Syndrome; D013921:Thrombocytopenia / Q000235:genetics; D013933:Thumb / Q000002:abnormalities