“…The vast majority of these cases have, in addition to HRS, MCA including skeletal anomalies. The described skeletal anomalies can be grouped into four main categories of: (i) craniosynostosis [Allain et al, 1976;Ives and Houston, 1980;Barone et al, 1993;Samson and Gardner, 1996;Shotelersuk et al, 2002], (ii) symphalangism [Park et al, 1972;Schinzel, 1980;Richieri-Costa and Pagnan, 1986;Schumacher et al, 1988;Sahoo et al, 1996], (iii) limb reduction, [Glass et al, 1994;Marles et al, 2003], and (iv) other skeletal defects [Keutel et al, 1970;Hughes et al, 1982;Van Gelderen, 1982;Alsing and Christensen, 1988;Chrzanowska et al, 1989;Faivre et al, 2001]. None of these cases would fit the findings in our patients.…”