Radiographic Synopsis

AP and lateral projections. Lack of radiographic evidence of joint fixation in infants owing to incomplete ossification; indirect signs may be hypoplasia of the affected joint, with abnormal middle phalanx epiph-ysis.

1. Proximal interphalangeal joint synostosis in hands and feet; carpotarsal coalition (proximal symphalangism)

2. Proximal interphalangeal joint synostosis in hands and feet; carpotarsal coalition; hypoplasia/aplasia of various phalanges; humeroradial synostosis; cervical vertebrae fusion; ankylosis of stapes (multiple synostoses syndrome)

3. Distal interphalangeal joint synostosis in hands and feet (2nd digit most commonly involved) (distal symphalangism)

4. First metacarpophalangeal joint synostosis (sym-phalangism Lewis type)

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