All Madelung deformities are not endocrine
A 13-year-old girl referred to us with a history of deformity of bilateral forearm from the age of 5 to 6 years. There was no history of pain in the joint of hands, trauma to the wrist and no history of similar illness in the family.\nPatient was moderately built and significantly short for her age []. With height of 130 cm (less than 3rd percentile). Upper segment was 69 cm, lower segment was 61 cm, weight of 35 kg and body mass index of 20.71 kg/m2. The arm forearm ratio was 1.78 suggestive of mesomelia. Secondary sexual characteristic Tanner-Whitehouse staging - B4 (breast), P4 (pubic hair), A3 (axillary hair) her elder brother had normal height for age and no any hand deformities and so were her parents.\nInvestigation showed hemoglobin of 12.5 g/dl, liver function test and renal function test were normal Ca++= 9.0 mg/dl alkaline phosphates 260 IU and phosphorus = 3.5 mg/dl. X-ray bilateral wrist showed malformed medial radial epiphysis with dorsal and ulnar shift and with increased length of phalanges suggestive of Madelung deformity []. Patient was evaluated for other causes of Madelung deformity. Her ultrasound abdomen showed no hepatomegaly or splenomegaly and had normal sized uterus and ovary X-ray spine and X-ray elbow were normal []. Her luteinizing hormone = −1.1 mIU/ml follicle stimulating hormone = 2.4 mIU/ml and karyotype was normal as was urine mucopolysaccharide screening.\nBased on the history, clinical examination, and investigations findings, the final diagnosis of LWD as a cause of Madelung deformity was made.