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      Pseudoachondroplasia: A rare cause of rhizomelic dwarfism

      case-report

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          Abstract

          Pseudoachondroplasia is a rare rhizomelic short-limbed skeletal dysplasia. Its inheritance is varied; autosomal dominant pattern and germline or somatic mutations can occur. Children at 2–3 years of age present with short height, gait disturbances, or limb deformities. Characteristic skeletal changes include shortening of long bones, predominantly of femur and humerus with irregular, flared metaphysis and fragmented epiphysis. Platyspondyly is also present, but the interpedicular distance is normal. The diagnosis is essentially based on imaging, and thus, it is important to be aware of the radiological features. Here, we report a case of two brothers where the elder sibling had classical radiological features of pseudoachondroplasia, whereas the younger one had early changes of this disorder.

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          Most cited references7

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          Mosaicism in pseudoachondroplasia.

          Pseudoachondroplasia (PSACH) is a spondylo-epi-metaphyseal dysplasia characterized by disproportionate short stature, generalized ligamentous laxity, and precocious osteoarthritis. PSACH is caused by mutations in the cartilage oligomeric matrix protein (COMP) gene, which codes for a noncollagenous protein expressed in the territorial matrix of chondrocytes. Autosomal dominant inheritance has been demonstrated in many families; however, autosomal recessive inheritance has been suggested in some severe familial cases. Alternatively, germline/somatic mosaicism has been proposed and is credible, since it has been shown that dominantly inherited and sporadic cases of PSACH are caused by the same genetic defect. Here, we present evidence demonstrating somatic mosaicism in two PSACH families that were originally considered to represent autosomal recessive inheritance. The results of this study suggest that autosomal recessive inheritance is unlikely and all cases of PSACH should be studied for mutations in COMP.
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            Metabolic and endocrine disorders affecting bone

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              Pseudoachondroplastic dysplasia.

              Pseudoachondroplasia is a heterogeneous inherited skeletal dysplasia in which dwarfism is a major feature. We report here a case of a 7 year old girl misdiagnosed as rickets, who presented with short stature, lordosis, genu varum and flexion deformities at both the elbows. Skeletal survey revealed epiphyseal and metaphyseal irregularities. A review of literature is also presented.
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                Author and article information

                Journal
                Indian J Orthop
                IJO
                Indian Journal of Orthopaedics
                Medknow Publications (India )
                0019-5413
                1998-3727
                Oct-Dec 2008
                : 42
                : 4
                : 477-479
                Affiliations
                University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India
                Author notes
                Correspondence: Dr. Anupama Tandon, Lecturer, Department of Radiology and Imaging, U.C.M.S. and GTB Hospital, Delhi, India. E-mail: zulutandon@ 123456sify.com
                Article
                IJO-42-477
                10.4103/0019-5413.43400
                2740353
                19753240
                e35c79da-cc35-46c6-b540-6c5397856225
                © Indian Journal of Orthopaedics

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Orthopedics
                rhizomelic dwarfism,pseudoachondroplasia,skeletal dysplasia
                Orthopedics
                rhizomelic dwarfism, pseudoachondroplasia, skeletal dysplasia

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