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Fong disease

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Trauma.

Patient Data

Age: 40 years
Gender: Male

Pelvis radiograph

x-ray

No fracture or malalignment. Bilateral iliac horns projecting laterally and bilateral flaring of the iliac crests and protuberant anterior superior iliac spines highly suggestive of nail-patella syndrome (Fong disease).

CT pelvis

ct

CT confirms the presence of bilateral iliac horns ("Fong prongs") which arise from the posterior surface of the iliac bones.

Renal transplant in the LIF.

Left knee radiographs

x-ray

Hypoplastic laterally subluxed patella. Enlarged tibial tuberosity. The lateral femoral condyle is slightly flattened and wider than expected.

Initial foot & ankle

x-ray

Hypoplasia of the radial head. Hypoplasia and fragmentation of the capitellum. Dislocated proximal radio-ulnar joint and posterior dislocation of the radio-capitellar joint. Absent radial notch of the ulna.

Case Discussion

This case nicely shows several of the skeletal manifestations of Fong disease (nail-patella syndrome). The patient was diagnosed with the syndrome as an adolescent following multiple episodes of radio-capitellar, PRUJ and patella dislocations.

The patient had renal failure and required renal transplant over a decade ago.

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