PMC2684999_01
PMC2684999_02
A 14-year-old girl with hypophosphatasia.. A. The general appearance of the patient with marked growth retardation and shortness in her right lower extremity.. B. The skin overlying the Bowdler spurs shows fibrotic dimpling and brown discoloration with bilateral pes planovalgus deformity of the feet.. C. Bilateral fibular Bowdler spurs.. D. An irregularity of the articular surfaces of both the femoral head and the acetabulums with narrowing of the joint space, and the diffuse osteoporosis and radiolucent areas in all the bones are prominent.
kjr-6-52-g001.jpg
PMC2684999_02_kjr-6-52-g001.jpg
F1
The skin overlying the Bowdler spurs showed fibrotic dimpling and brown discoloration (Figs. 1A, B). She had bilateral pes planovalgus (Figs. 1A, B). The Bowdler spurs in both fibulae and in the right hip joint femoral head were directed anteriorly and superiorly (Fig. 1C). The femoral necks were short and wide, and there was an increase of the collodiaphyseal angle with anterosuperior displacement of the femoral heads (Fig. 1D). There was diffuse osteoporosis and radioluscent areas in all the bones (Figs. 1C, D).