Contributed by: Dr. Shubha R Phadke  
  Email: shubharaophadke@gmail.com  
  This 5 year old intellectually normal girl presented with short stature and joint deformities. Radiographs of the spine, hip, knees and hands are shown. Identify the condition.  
 

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Answer to PhotoQuiz 30
Pycnodysostosis (OMIM # 265800)
Pycnodysostosis is an autosomal recessive disorder characterized by short stature, osteosclerosis, acroosteolysis of the distal phalanges and increased bone fragility with predisposition to fractures. Typical craniofacial features of this condition include large skull with wormian bones, delayed closure of the anterior fontanelle, a small mandible and delayed eruption of primary and secondary dentition. It is caused by homozygous or compound heterozygous mutations in the CTSK (cathepsin K) gene.
 
Correct responses were given by:
1. Jagadish Bhat, Goa
2. Diksha Shirodkar, Goa
3. Leena Shingavi, Pune
4. Poonam Singh Gambhir, Lucknow
5. Kalpana Gowrishankar, Chennai
6. Deepti Saxena, Lucknow
7. J.K. Dissanayake, Peradeniya, Sri Lanka
8. Atanu Kumar Dutta, Kolkata
9. Ravi Goyal, Kota, Rajasthan
10. Ashish Gupta, New Delhi