Genetic conditions

Abnormalities of the musculoskeletal system are seen in a number of genetic conditions (chromosomal, single gene and mitochondrial disorders). Features may present at birth (e.g., hypotonia), but often may become more apparent during childhood (e.g., hypermobility, camptodactyly).

Downs syndrome - Trisomy 21: General hypotonia, Hypermobility, Scoliosis, Inflammatory arthritis, Cervical spine instability, Hip dislocation/subluxation, Short stature.

DiGeorge syndrome - 22q11 deletion: Inflammatory arthritis, Scoliosis, Short stature, Micrognathia.

Turner’s syndrome – 46XO: Increased carrying angle at the elbows, Short stature / webbed neck, Volar deformity at the wrist, short 4th metacarpals.

Sickle cell disease - Autosomal recessive: Bone pain and painful joint swelling, Osteomyelitis and septic arthritis, Osteonecrosis.

Cystic Fibrosis - Autosomal recessive: Arthralgia, Inflammatory arthritis, Hypertrophic pulmonary osteoarthropathy (clubbing).

Mucopolysaccharidoses -  Autosomal recessive: these are a spectrum of conditions with a broad range of features. Joint contractures (often upper limb) occur, but some forms result in joint hypermobility. Other festures include Claw hand / Trigger fingers, Carpal Tunnel syndrome , Scoliosis / kyphosis, Toe walking, Delayed milestones / delayed walking / abnormal gait. Other systems can be affected (e.g., recurrent chest or ear infections, heart valve problems, herniae).

Achondroplasia - Autosomal dominant: Shortened limbs and dwarfism, Bow legs.

Marfan's syndrome - Autosomal dominant: Tall stature, Disproportionately long limbs, Arachnodactyly, Pectus excavatum/carinatum, Pes planus, High arched palate, Protrusio acetabulae.

Duchenne Muscular Dystrophy - X linked recessive: Abnormal Gait / delayed walking, Proximal muscle weakness, Scoliosis, Limp and toe-walking.

Hypophosphataemic or Vitamin D resistant Rickets - X linked recessive: Bow legs, Joint pain, Limp.

Haemophilias (A and B) - X linked recessive: Haemarthrosis.