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Note what signs you see.
I (W. Wertelecki, M.D.) see a dysmorphic left hand and fingers – the proportions and posture of the thumb-index are abnormal – the index is permanently flexed at the proximal joint and extended in the distal joint – the axis of the index is also deviated.
Perspective: Some anomalies are virtually pathognomonic (nearly specific), in this instance, such finger dysmorphisms are highly characteristic of trisomy 18+.
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