Clinodactyly is a descriptive term that refers to a radial angulation at an interphalangeal joint in the radio-ulnar or palmar planes. It typically affects the fifth finger.
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Epidemiology
The estimated incidence is highly variable dependent on sampling and has been reported to range between 1-18% ref.
Pathology
Clinodactly can result from a vast number of pathologies ranging from congenital to acquired.
Genetics
As well as being sporadic, it can run in families with an autosomal recessive inheritance.
Associations
Although clinodactyly is often an isolated phenomenon and can be even a normal variant, there are numerous described associations which include:
-
aneuploidic syndromic
- Down syndrome: may be seen in up to 60% of infants with Down syndrome 3
- Klinefelter syndrome
- trisomy 18
- Turner syndrome
- non-aneupliodic syndromic
- non-syndromic
Radiographic features
Ultrasound
Shortening or absence of the fifth finger middle phalanx can be diagnosed on antenatal ultrasound by comparing the lengths with the fourth finger middle phalanx ref.
Treatment and prognosis
If detected in isolation it carries an excellent prognosis.
Practical points
Due to its association with chromosomal anomalies, it is considered by some authorities as a "soft sign" if detected in an antenatal ultrasound scan 5.
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