Radiographic Synopsis

AP projections

1. Mesophalangeal cones type 12 of Giedion; ivory epiphyses; short metacarpals/metatarsals, especially the 4th and 5th; Perthes-like changes of hips (tricho-rhino-phalangeal syndrome type I)

2. Mesophalangeal cones type 12 of Giedion; ivory epiphyses; multiple exostoses; short phalanges and/or metacarpals; Perthes-like changes of hips (tricho-rhino-phalangeal syndrome type II)

3. Cone-shaped epiphyses; severe shortening of all phalanges and metacarpals (tricho-rhino-pha-langeal syndrome type III)

4. Cone-shaped epiphyses; short metacarpals and metatarsals, in variable combination; short phalanges, especially distal (not mandatory) (PHP, PPHP)

5. 'Flattened half-moon' or 'hat-like' mesophalangeal cones; metaphyseal abnormalities in the tubular bones (metaphyseal chondrodysplasia, McKusick type)

6. Widespread cone-shaped epiphyses; severe brachydactyly (peripheral dysostosis)

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