Fig. 3.

Patient 2. Radiological examinations at the age of 12 years: Normal thorax configuration, enlarged heart (a). Symmetrical valgus deformity of the knees (b). Postaxial hexadactyly of both hands with acroosteolyses in the distal phalanges II–VI and a symmetrical synostosis of metacarpals V and IV (c), cone-shaped distal phalanges of both feet, valgus deformity of both ankles, and hexadactyly of the right foot (d). Examination at the age of 30 years: mesomelic shortening of the legs (e) and synostosis of the additional fingers on both hands (f).