Turner syndrome

  • monosomy 45, XO
  • 1 in 3000-5000
  • skeletal growth arrest at 15 years
Cardia
  • coarctation
  • aortic stenosis
  • idiopathic hypertension
  • lymphangiectasia, generalized hydros
head and neck
  • webbed neck
  • high palate
  • low irregular nuchal line
  • nuchal cystic hygroma
endocrine
  • thyromegaly
  • pigmented nevi, keloid formation
  • sexual infantilism
  • primary amenorrhea
  • absent secondary sex characteristics
  • raised urinary gonadotrophins
chest
  • wide spaced nipples
  • shield shaped chest
  • thin narrow ribs with pseudonotching
  • thin lateral clavicle margins
abdomen
  • horseshoe kidney
  • streak ovaries
  • prepubertal uterus
skull
  • basilar impression, basal angle >140 degrees
  • parietal thinning
  • small sella
  • hypertelorism
upper limb
  • positive metacarpal sign: shortening of 3rd and 4th metacarpals
  • positive carpal sign: scaphoid-lunate-triquetrum angle <117 degrees
  • phalangeal preponderance: proximal and distal phalanx length > 4th metacarpal by >3 mm
  • shortening of 2nd and 5th middle phalanx
  • drumstick distal phalanges: slender shaft, large distal head
  • insetting of epiphyses into base of adjacent metaphyses
  • Madelung deformity: shortening of ulna, absence of ulnar styloid process
  • cubitus valgus: radial tilt of articular surface of trochlea
lower limb
  • tibia vara
  • enlarged medial femoral condyle
  • depression of medial tibial plateau
  • exostosis from medial border of proximal tibial metaphysics
  • shortening of 1st, 4th and 5th metatarsals
  • pes cavus