Figure 5.2.

Ullrich congenital muscular dystrophy (UCMD). The patient in (A) is able to walk, but note knee and elbow contractures. This patient lost the ability to walk at 9 years of age. The patient in (B) shows typical contractures in the nonambulatory patient, affecting the pectoralis, elbows, hips, knees, and Achilles tendons. The feet in (C) show the typical prominent calcaneus and the soft plantar skin, whereas (D) demonstrates the striking distal hyperlaxity seen in the fingers in a patient with UCMD. (D: Courtesy of Marjo van der Knaap, Amsterdam, Netherlands)