PMC2817541_01
PMC2817541_02
Patient: mesomelic shortening of the left leg with internal rotation of the homolateral foot. The great toe is hypoplastic and bifid. The lateral malleous is protruding as a result from disproportionate development of the tibia and fibula.
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fig1
The lateral malleous was protruding thus suggesting a disproportion between the development of the tibia and fibula (Figure 1).
Accessory scrotum originating from the normally developed scrotal sac.
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fig2
Further examination revealed bifid scrotum and left-sided cryptorchidism (Figure 2).
X-ray: complete agenesis of the left tibia, shortened and thickened fibula, and hypoplastic distal femoral epiphysis.
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fig3
Total X-ray examination revealed complete agenesis of the left tibial with a shortened and thickened fibula and hypoplastic distal femoral epiphysis (Figure 3).
The first metatarsal bone is smaller and longer as resulting from duplication of a more posterior ray. There is a rudimentary accessory metatarsal bone on the tibial side. The great toe is hypoplastic and triphalageal, while a small monophalangeal extradigit is visible on the tibial side of the first toe. The navicular and cuboid bones are unossified.
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fig4
First metatarsal bone was smaller and longer than expected and resembled as resulting from duplication of a more posterior ray; there was a rudimentary accessory metatarsal bone on the tibial side; the great toe was hypoplastic and triphalangeal, while a small monophalangeal extradigit was visible on the tibial side of the first toe; the navicular and cuboid bones were unossified (Figure 4).