Hepatomegaly, and Interphalangeal joint contracture of finger

Diseases related with Hepatomegaly and Interphalangeal joint contracture of finger

In the following list you will find some of the most common rare diseases related to Hepatomegaly and Interphalangeal joint contracture of finger that can help you solving undiagnosed cases.

Top matches:

Muckle-Wells syndrome (MWS) is an intermediate form of cryopyrin-associated periodic syndrome (CAPS; see this term) and is characterized by recurrent fever (with malaise and chills), recurrent urticaria-like skin rash, sensorineural deafness, general signs of inflammation (eye redness, headaches, arthralgia/myalgia) and potentially life-threatening secondary amyloidosis (AA type).

MUCKLE-WELLS SYNDROME Is also known as neutrophilic urticaria

Related symptoms:

  • Short stature
  • Anemia
  • Hepatomegaly
  • Fever
  • Optic atrophy


SOURCES: ORPHANET MENDELIAN

More info about MUCKLE-WELLS SYNDROME

Geleophysic dysplasia is a rare skeletal dysplasia characterized by short stature, prominent abnormalities in hands and feet, and a characteristic facial appearance (described as "happy'').

GELEOPHYSIC DYSPLASIA Is also known as geleophysic dwarfism

Related symptoms:

  • Seizures
  • Global developmental delay
  • Short stature
  • Growth delay
  • Hypertelorism


SOURCES: ORPHANET OMIM MENDELIAN

More info about GELEOPHYSIC DYSPLASIA

Mitochondrial encephalo-cardio-myopathy due to TMEM70 mutation is characterized by early neonatal onset of hypotonia, hypetrophic cardiomyopathy and apneic spells within hours after birth accompanied by lactic acidosis, hyperammonemia and 3-methylglutaconic aciduria.

TMEM70-RELATED MITOCHONDRIAL ENCEPHALO-CARDIO-MYOPATHY Is also known as encephalocardiomyopathy, mitochondrial, neonatal, due to atp synthase deficiency|mitochondrial encephalo-cardio-myopathy due to f1fo atpase deficiency|mitochondrial encephalo-cardio-myopathy due to isolated mitochondrial respiratory chain complex v defici

Related symptoms:

  • Seizures
  • Global developmental delay
  • Generalized hypotonia
  • Microcephaly
  • Ataxia


SOURCES: MESH ORPHANET OMIM MENDELIAN

More info about TMEM70-RELATED MITOCHONDRIAL ENCEPHALO-CARDIO-MYOPATHY

Other less relevant matches:

This autosomal recessive systemic autoinflammatory disorder is characterized by early childhood onset of annular erythematous plaques on the face and extremities with subsequent development of partial lipodystrophy and laboratory evidence of immune dysregulation. More variable features include recurrent fever, severe joint contractures, muscle weakness and atrophy, hepatosplenomegaly, basal ganglia calcifications, and microcytic anemia (summary by Agarwal et al., 2010; Kitamura et al., 2011; Arima et al., 2011).This disorder encompasses Nakajo-Nishimura syndrome (NKJO); joint contractures, muscular atrophy, microcytic anemia, and panniculitis-induced lipodystrophy (JMP syndrome); and chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature syndrome (CANDLE). Among Japanese patients, this disorder is best described as Nakajo-Nishimura syndrome, since both Nakajo (1939) and Nishimura et al. (1950) contributed to the original phenotypic descriptions. Genetic Heterogeneity of Proteasome-Associated Autoinflammatory SyndromeSee also PRAAS2 (OMIM ), caused by mutation in the POMP gene (OMIM ) on chromosome 13q12, and PRAAS3 (OMIM ), caused by mutation in the PSMB4 gene (OMIM ) on chromosome 1q21.

PROTEASOME-ASSOCIATED AUTOINFLAMMATORY SYNDROME 1; PRAAS1 Is also known as chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature syndrome|candle|joint contractures, muscular atrophy, microcytic anemia, and panniculitis-induced lipodystrophy|autoinflammation, lipodystrophy, and dermatosis syndrome|n

Related symptoms:

  • Intellectual disability
  • Seizures
  • Short stature
  • Failure to thrive
  • Muscle weakness


SOURCES: OMIM ORPHANET MENDELIAN

More info about PROTEASOME-ASSOCIATED AUTOINFLAMMATORY SYNDROME 1; PRAAS1

Fetal Gaucher disease is the perinatal lethal form of Gaucher disease (GD; see this term).

FETAL GAUCHER DISEASE Is also known as perinatal lethal gaucher disease|gaucher disease, collodion type

Related symptoms:

  • Seizures
  • Generalized hypotonia
  • Microcephaly
  • Hypertelorism
  • Micrognathia


SOURCES: ORPHANET MESH OMIM MENDELIAN

More info about FETAL GAUCHER DISEASE

GM1-Gangliosidosis is an autosomal recessive lysosomal storage disease characterized by accumulation of ganglioside substrates in lysosomes. Clinically, patients show variable degrees of neurodegeneration and skeletal abnormalities. There are 3 main clinical variants categorized by severity and variable residual beta-galactosidase activity. Type I, or infantile form, shows rapid psychomotor deterioration beginning within 6 months of birth, generalized central nervous system involvement, hepatosplenomegaly, facial dysmorphism, macular cherry-red spots, skeletal dysplasia, and early death. Type II, or late-infantile/juvenile form (OMIM ), has onset between 7 months and 3 years, shows generalized central nervous system involvement with psychomotor deterioration, seizures, localized skeletal involvement, and survival into childhood. Hepatosplenomegaly and cherry-red spots are usually not present. Type III, or adult/chronic form (OMIM ), shows onset from 3 to 30 years and is characterized by localized skeletal involvement and localized central nervous system involvement, such as dystonia or gait or speech disturbance. There is an inverse correlation between disease severity and residual enzyme activity (Suzuki et al., 2001).See also Morquio B disease (OMIM ), an allelic disorder with skeletal anomalies and no neurologic involvement.The GM2-gangliosidoses include Tay-Sachs disease (OMIM ) and Sandhoff disease (OMIM ).

GM1-GANGLIOSIDOSIS, TYPE I Is also known as gangliosidosis, generalized gm1, type 1|gangliosidosis, generalized gm1, type i|glb1 deficiency|gangliosidosis, generalized gm1, infantile form|beta-galactosidase-1 deficiency

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Short stature
  • Scoliosis


SOURCES: ORPHANET OMIM MENDELIAN

More info about GM1-GANGLIOSIDOSIS, TYPE I

Medium match HENNEKAM SYNDROME

Hennekam syndrome is characterised by the association of lymphoedema, intestinal lymphangiectasia, intellectual deficit and facial dysmorphism.

HENNEKAM SYNDROME Is also known as lymphedema-lymphangiectasia-intellectual disability syndrome|lymphatic dysplasia, generalized|hennekam lymphangiectasia-lymphedema syndrome

Related symptoms:

  • Intellectual disability
  • Seizures
  • Hearing impairment
  • Scoliosis
  • Growth delay


SOURCES: ORPHANET OMIM MENDELIAN

More info about HENNEKAM SYNDROME

Bohring-Opitz syndrome is characterised by intrauterine growth retardation (IUGR), failure to thrive, facial dysmorphism (prominent metopic suture and forehead nevus flammeus, a low frontal and temporal hairline with hirsutism, puffy cheeks, upslanting palpebral fissures, exophthalmos, hypertelorism, cleft lip and palate, retrognathia and low set ears), flexion deformities of the elbows and wrists, camptodactyly, ulnar deviation of the fingers, foot anomalies and severe developmental delay. Less than 20 patients have been described so far. Although the large majority of reported cases occurred sporadically, autosomal recessive inheritance has also been reported.

BOHRING-OPITZ SYNDROME Is also known as c-like syndrome|bos syndrome|bohring syndrome|oberklaid-danks syndrome|opitz trigonocephaly-like syndrome

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Short stature
  • Generalized hypotonia


SOURCES: MESH OMIM ORPHANET MENDELIAN

More info about BOHRING-OPITZ SYNDROME

Medium match H SYNDROME

H syndrome is a systemic inherited histiocytosis, with characteristic cutaneous findings accompanying systemic manifestations. H syndrome refers to the major clinical findings of hyperpigmentation, hypertrichosis, hepatosplenomegaly, heart anomalies, hearing loss, hypogonadism, low height, and occasionally, hyperglycemia/diabetes mellitus. Due to overlapping clinical features, H syndrome is now considered to include pigmented hypertrichosis with insulin dependent diabetes mellitus syndrome (PHID), Faisalabad histiocytosis (FHC) and familial sinus histiocytosis with massive lymphadenopathy (FSHML).

H SYNDROME Is also known as sinus histiocytosis and massive lymphadenopathy|hjcd|shml|hyperpigmentation, cutaneous, with hypertrichosis, hepatosplenomegaly, heart anomalies, and hypogonadism with or without hearing loss|h syndrome|faisalabad histiocytosis|pigmented hypertrichosis wi

Related symptoms:

  • Global developmental delay
  • Short stature
  • Generalized hypotonia
  • Hearing impairment
  • Growth delay


SOURCES: MESH ORPHANET OMIM MENDELIAN

More info about H SYNDROME

Hurler-Scheie syndrome is the intermediate form of mucopolysaccharidosis type 1 (MPS1; see this term) between the two extremes Hurler syndrome and Scheie syndrome (see these terms); it is a rare lysosomal storage disease, characterized by skeletal deformities and a delay in motor development.

HURLER-SCHEIE SYNDROME Is also known as mucopolysaccharidosis type 1h/s|mucopolysaccharidosis type ih/s|mpsih/s|mps1-hs|mps1h/s

Related symptoms:

  • Intellectual disability
  • Global developmental delay
  • Short stature
  • Hearing impairment
  • Scoliosis


SOURCES: ORPHANET MENDELIAN

More info about HURLER-SCHEIE SYNDROME

Top 5 symptoms//phenotypes associated to Hepatomegaly and Interphalangeal joint contracture of finger

Symptoms // Phenotype % cases
Camptodactyly of finger Common - Between 50% and 80% cases
Hepatosplenomegaly Common - Between 50% and 80% cases
Seizures Common - Between 50% and 80% cases
Hypertelorism Common - Between 50% and 80% cases
Short stature Common - Between 50% and 80% cases

Other less frequent symptoms

Patients with Hepatomegaly and Interphalangeal joint contracture of finger. may also develop some of the following symptoms:

Common Symptoms - More than 50% cases

Splenomegaly

Uncommon Symptoms - Between 30% and 50% cases

Flexion contracture

Common Symptoms - More than 50% cases

Global developmental delay

Uncommon Symptoms - Between 30% and 50% cases

Congestive heart failure

Common Symptoms - More than 50% cases

Cardiomegaly

Uncommon Symptoms - Between 30% and 50% cases

Respiratory insufficiency Intellectual disability Growth delay Abnormal facial shape Anteverted nares Retrognathia Long philtrum Abnormality of the kidney Muscular hypotonia Intellectual disability, mild Severe short stature Talipes equinovarus Wide nasal bridge Failure to thrive Low-set ears Generalized hypotonia Inguinal hernia Edema Arthralgia Anemia Elbow flexion contracture Scoliosis Camptodactyly Hearing impairment Depressed nasal bridge Proptosis Cardiomyopathy Intrauterine growth retardation Sensorineural hearing impairment Macroglossia Gingival overgrowth Atrial septal defect Conductive hearing impairment Hirsutism Microcephaly Hernia Dysostosis multiplex Cryptorchidism Recurrent respiratory infections Hypertrichosis Umbilical hernia Lymphadenopathy Short neck Apnea Polyhydramnios Hyperkeratosis Ventriculomegaly Hyperreflexia Flat face Strabismus Skeletal muscle atrophy Micrognathia Thickened skin Ventricular septal defect Dilatation Delayed skeletal maturation Joint stiffness Osteopenia Optic atrophy Episcleritis Ichthyosis Elevated erythrocyte sedimentation rate Short foot Fever Full cheeks Glaucoma

Rare Symptoms - Less than 30% cases

Narrow palate Hypertriglyceridemia Lymphopenia Hyperpigmentation of the skin Depressed nasal ridge Lipodystrophy Increased antibody level in blood Hydrops fetalis Limitation of joint mobility Knee flexion contracture Abnormality of the liver Elevated hepatic transaminase Macrotia Abnormal diaphysis morphology Abnormality of dental morphology Thrombocytopenia Recurrent infections Pleural effusion Muscle weakness Abnormal heart valve morphology Multiple joint contractures Cognitive impairment Generalized hirsutism Microcytic anemia Thickened ribs Pectus carinatum High, narrow palate Epicanthus Developmental regression Pes cavus Abdominal pain Low-set, posteriorly rotated ears Intellectual disability, severe Diarrhea Abnormality of the dentition Narrow mouth Conjunctivitis Respiratory distress Syndactyly Hypothyroidism Vesicoureteral reflux High palate Spasticity Macrocephaly Restrictive ventilatory defect Everted lower lip vermilion Stiff skin Panniculitis Craniosynostosis Ascites Narrow chest Malabsorption Abnormality of the foot Sparse axillary hair Encephalitis Hypoplastic iliac wing Microtia Kyphosis Upslanted palpebral fissure Tremor Skeletal dysplasia Wide mouth Talipes Smooth philtrum Short palm Ataxia Small hand Severe hydrops fetalis J-shaped sella turcica Nasal obstruction Skin rash Communicating hydrocephalus Corneal opacity Posteriorly rotated ears Tracheal stenosis Delayed puberty Toe walking Retinopathy Wide intermamillary distance Platyspondyly Synophrys Coxa valga Joint contracture of the hand Aortic valve stenosis Cleft upper lip Frontal bossing Sleep apnea Coarse facial features Arrhythmia Neonatal hypotonia Cerebral cortical atrophy Short philtrum Nonimmune hydrops fetalis Short nose Intellectual disability, moderate Hypertrophic cardiomyopathy Premature birth Pectus excavatum Oligohydramnios Hernia of the abdominal wall Arthritis Abnormal form of the vertebral bodies Epistaxis Hypergonadotropic hypogonadism Scleroderma Bilateral sensorineural hearing impairment Aspiration Blue sclerae Primary amenorrhea Lipoatrophy Dyspnea Gynecomastia Hallux valgus Epidermal acanthosis Pes planus Mitral valve prolapse Hypotrichosis Psoriasiform dermatitis Azoospermia Growth hormone deficiency Decreased testicular size Recurrent fractures Bronchiectasis Polyneuropathy Amenorrhea Type I diabetes mellitus Plagiocephaly Stridor Overgrowth Abnormal cardiac septum morphology Hyperglycemia Leukocytosis Osteolysis Telangiectasia Facial capillary hemangioma Micropenis Hemangioma Ulnar deviation of finger Dislocated radial head Biparietal narrowing Broad palm Short thorax Supernumerary nipple Overlapping toe Hypoplasia of the brainstem Nephroblastoma Elbow dislocation Trigonocephaly CNS hypomyelination Sacral dimple Underdeveloped supraorbital ridges Joint dislocation Low anterior hairline Bradycardia Short toe Decreased body weight Heterotopia Intellectual disability, profound High myopia Congenital diaphragmatic hernia Narrow forehead Dandy-Walker malformation Convex nasal ridge Intestinal malrotation Prominent metopic ridge Nevus flammeus Diabetes mellitus Mesomelic/rhizomelic limb shortening Hypogonadism Pneumonia Alopecia Abnormal heart morphology Patent ductus arteriosus Clinodactyly Hydrocephalus Brachydactyly Ptosis Delayed peripheral myelination Hyperechogenic pancreas Nevus flammeus of the forehead Facial hemangioma Severe intrauterine growth retardation Ulnar deviation of the wrist Accessory oral frenulum Atrophy of the spinal cord Deep plantar creases Broad alveolar ridges Abnormal anterior chamber morphology Thick hair Deep palmar crease Abnormality of the pancreas Abnormality of the optic nerve Capillary hemangioma Thoracolumbar scoliosis Severe failure to thrive Polycythemia Limb undergrowth Episodic fever Cor pulmonale Abnormality of the optic disc Aortic valve calcification Abnormality of the radius Corneal crystals Peripheral edema Abnormal nerve conduction velocity Wide cranial sutures Platybasia Carpal bone hypoplasia Abnormal cornea morphology Myelopathy Shield chest Sagittal craniosynostosis Flared iliac wings Dilation of lateral ventricles Hip subluxation Papilledema Hyperactive deep tendon reflexes Spinal canal stenosis Rhinitis Protuberant abdomen Peripheral visual field loss Blepharitis Obstructive sleep apnea Sparse pubic hair Chronic sinusitis Spinal cord compression Diastasis recti Abnormality of the ulna Hydrocele testis Broad ribs Abnormality of the gingiva Mitral valve calcification Exertional dyspnea Abnormality of lysosomal metabolism Abnormality of the styloid process of ulna Contractures of the joints of the upper limbs Increased size of nasopharyngeal adenoids Widely patent coronal suture Abnormality of glycosaminoglycan metabolism Abnormality of the lumbar spine Abnormality of the glenoid fossa Abnormality of cranial sutures Anterior scalloping of vertebral bodies Abnormality of femoral epiphysis Abnormal metaphyseal trabeculation Abnormality of the sella turcica Abnormality of the skull base Posterior scalloping of vertebral bodies Short tubular bones of the hand Heparan sulfate excretion in urine Dermatan sulfate excretion in urine Delayed menarche Urinary glycosaminoglycan excretion Cervical instability Frontal hirsutism Optic nerve compression Progressive flexion contractures Abnormality of the acetabulum Small abnormally formed scapulae Abnormality of mucopolysaccharide metabolism Limited shoulder movement Abnormality of the tonsils Exercise-induced muscle stiffness Dilated third ventricle Abnormality of the breast Arthropathy Heart murmur Severe sensorineural hearing impairment Generalized lymphadenopathy Kyphoscoliosis Constipation Headache Nevus Motor delay Visual impairment Seborrheic keratosis Retroperitoneal fibrosis Upper eyelid edema Bilateral camptodactyly Cervical lymphadenopathy Snoring Facial telangiectasia Myelofibrosis Corneal arcus Nyctalopia Recurrent pharyngitis Exocrine pancreatic insufficiency Enlarged kidney Abnormal eyebrow morphology Aspiration pneumonia Varicose veins Decreased serum testosterone level Skin nodule Hyperplasia of the maxilla Histiocytosis Reticulocytopenia Chronic rhinitis Abnormality of cardiovascular system physiology Pancreatic hypoplasia Broad finger Abnormal pyramidal sign Dolichocephaly Chronic otitis media Recurrent otitis media Back pain Coarse hair Easy fatigability Increased intracranial pressure Arnold-Chiari malformation Abnormality of the metacarpal bones Widely spaced teeth Opacification of the corneal stroma Abnormality of dental enamel Congenital hip dislocation Short ribs Abnormal vertebral morphology Abnormality of retinal pigmentation Lower limb spasticity Lumbar hyperlordosis Hypermetropia Wide nose Carious teeth Limb muscle weakness Genu valgum Lower limb muscle weakness Astigmatism Retinal degeneration Thick vermilion border Abnormality of the ribs Sleep disturbance Asthma Otitis media Hip dysplasia Progressive visual loss Microdontia Gait disturbance Reduced number of teeth Tapered finger Finger swelling Nephropathy Nephrotic syndrome Jaundice Abnormality of the genital system Vasculitis Hypertonia Cranial nerve paralysis Dysphagia Abnormal palate morphology Urticaria Abnormality of the voice Adipose tissue loss Erythema nodosum Arthrogryposis multiplex congenita Hypochromic anemia Flexion contracture of toe Generalized lipodystrophy Immune dysregulation Clubbing of fingers Abnormally large globe Myositis Rimmed vacuoles Basal ganglia calcification Hypermelanotic macule Long fingers Glucose intolerance Abnormality of the pinna Abnormality of eye movement Bone pain Intracranial hemorrhage Distal arthrogryposis Congenital ichthyosiform erythroderma Hypokinesia Petechiae Opisthotonus Abnormality of coagulation Thoracic hypoplasia Neonatal respiratory distress Akinesia Apathy Congenital contracture Ectropion Poor suck Hepatic failure Purpura Abnormality of the face Open mouth Progressive neurologic deterioration Pancytopenia Decreased fetal movement Cerebral calcification Underdeveloped nasal alae Abnormal bleeding Triangular face Metabolic acidosis Pulmonary hypoplasia Growth abnormality Thick lower lip vermilion Fetal akinesia sequence Hypoplasia of the capital femoral epiphysis Respiratory failure Encephalopathy Hypospadias Cerebellar atrophy Thin upper lip vermilion Hypertension Cataract Short metacarpals with rounded proximal ends Irregular capital femoral epiphysis Tricuspid stenosis Tip-toe gait Wrist flexion contracture Thickened helices Small for gestational age Lack of skin elasticity Mitral stenosis Ovoid vertebral bodies Right ventricular hypertrophy High pitched voice Bilateral talipes equinovarus Cone-shaped epiphysis Short long bone Bicuspid aortic valve Aortic regurgitation Round face Small nail Acidosis Lactic acidosis Prominent nose Gastroparesis Progressive sensorineural hearing impairment Inability to walk Uveitis Scarring Erythema Hyperhidrosis Babinski sign Broad foot Abnormality of the nose Recurrent aphthous stomatitis Pain Abnormal pulmonary valve morphology Hyperalaninemia Renal amyloidosis 3-Methylglutaconic aciduria Moderate global developmental delay Abnormal aortic valve morphology Flat occiput Hyperammonemia Aplasia/Hypoplasia of the corpus callosum Leukoencephalopathy Microretrognathia Intention tremor Pulmonary arterial hypertension Aciduria Increased serum lactate Cardiorespiratory arrest Overlapping fingers Long face Pyloric stenosis Hypoproteinemia Arteriovenous malformation Edema of the lower limbs Polysplenia Coronal craniosynostosis External ear malformation Palpebral edema Increased number of teeth Cutaneous finger syndactyly Pericardial effusion Ectopic kidney Hypoalbuminemia Ventricular hypertrophy Protein-losing enteropathy Oligodontia Cutaneous syndactyly Abnormal intestine morphology Spina bifida occulta Horseshoe kidney Hypocalcemia Bilateral single transverse palmar creases Lymphedema Pachygyria Decreased antibody level in blood Delayed eruption of teeth Finger syndactyly Generalized edema Periorbital edema Respiratory tract infection Neoplasm Oral cleft Severe global developmental delay Cleft lip Muscular hypotonia of the trunk Gastroesophageal reflux Prominent forehead Agenesis of corpus callosum Abnormality of cardiovascular system morphology Hypoplasia of the corpus callosum Myopia Feeding difficulties Cleft palate Pleural lymphangiectasia Rectal prolapse Pericardial lymphangiectasia Thyroid lymphangiectasia Mild postnatal growth retardation Benign neoplasm of the central nervous system Conical incisor Pulmonary lymphangiectasia Lymphangioma Erysipelas Intestinal lymphangiectasia Abnormal oral mucosa morphology Primary hypothyroidism Chylothorax Broad forehead Hydronephrosis Congenital nonbullous ichthyosiform erythroderma Abnormal pupillary function Weight loss Dementia Dystonia Blindness Abnormality of the skeletal system Nystagmus Mild fetal ventriculomegaly Enlarged fetal cisterna magna Abnormality of the microglia Hydropic placenta Low voltage EEG Abnormality of the small intestine Decreased beta-glucocerebrosidase protein and activity Hyperlordosis Sudden episodic apnea Desquamation of skin soon after birth Myocardial necrosis Hepatic necrosis Abnormality of the spinal cord Generalized hyperkeratosis Everted upper lip vermilion Extramedullary hematopoiesis Pneumothorax Astrocytosis Abnormality of the spleen Abnormality of the larynx Mandibular prognathia Dilated cardiomyopathy Hyperactivity Exaggerated startle response Midface retrusion Malar flattening Abnormality of metabolism/homeostasis Abnormality of ganglioside metabolism Decreased beta-galactosidase activity Cerebral degeneration Abnormality of the scrotum Angiokeratoma corporis diffusum Cherry red spot of the macula Rough bone trabeculation Hypoplastic vertebral bodies Vacuolated lymphocytes Psychomotor deterioration Abnormality of movement Aplasia/Hypoplasia of the abdominal wall musculature Abnormality of the retinal vasculature Beaking of vertebral bodies Generalized dystonia Bundle branch block Abnormality of the urinary system Myalgia Abnormality of epiphysis morphology Abnormality of the metaphysis Abnormality of the skin Broad nasal tip Abdominal distention Neurodegeneration Abnormality of the humeral epiphysis


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