Hajdu-Cheney syndrome

Last revised by Mostafa El-Feky on 31 Jul 2021

Hajdu-Cheney syndrome is a very rare connective tissue disorder with only 50 cases reported in the literature 7.

It is mostly diagnosed in adulthood or adolescence with the presence of a positive family history. There has been no link between severity of disease and age of diagnosis 3. Clinical features include:

  • short stature; premature loss of dentition; short webbed neck
  • pseudoclubbing; shortening of digits; pain in digits
  • optical atrophy; optic disc edema
  • hearing loss (conductive or sensorineural)
  • frontal and occipital headaches (due to basilar invagination)
  • craniofacial features: frontal bossing, widely spaced eyes, micrognathia, long philtrum, flat nasal bridge, coarse hair, low set ears and a low hairline

It is associated with osteoporosis, bony deformities and acro-osteolysis. It follows an autosomal dominant inheritance but can also result from spontaneous de novo mutations.

Diagnosis involves genetic testing searching for the truncating mutation in the terminal exon of NOTCH2 4.

  • acro-osteolysis
  • transverse band of osteolysis in distal phalanges is characteristic
  • distal to proximal osteolysis is also seen
  • hypoplastic maxilla
  • malalignment of teeth
  • wide mandibular angle 

Management is symptomatic and involves regular follow-up. Prevention of osteoporosis, vitamin D and bisphosphonates may also have a role 6.

First described by Nicholas Hajdu (1908–1987), Hungarian-English radiologist in 1948 as cranioskeletal dysplasia and later in 1965, by William D. Cheney (1899–1985), American radiologist as acro-osteolysis 1,2.

These involve other causes of acro-osteolysis and can be differentiated radiologically 5. Amongst others, they include the following:

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Cases and figures

  • Case 1
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