Mucopolysaccharidosis type VI - Maroteaux Lamy syndrome
Patient with coarse facial features, cardiac murmure, gibbus and dental decay.
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Bullet-shaped metacarpal bones and phalanges.
Slanting/ convergent distal radius and ulna. Osteopenic appearance of the wrist and hand bones with diffusely coarse trabecular bone.
Leucocyte enzyme assay identified the MPS type as 6 - Maroteaux-Lamy syndrome.