What is Arachnodactyly? What is Metacarpal Index?

• Arachnodactyly ("Spider fingers") means abnormally long and thin fingers compared to the size of the palm
• Derived from the Greek word " Arachne" - Spider, "Daktylos" - Finger
• Arachne word is derived from Greek mythology where a maiden named Arachne was cursed and turned to a spider by the Greek Goddess Athena, when Arachne  a skilled weaver challenged her to a weaving contest
• Seen in Marfan's Syndrome, Homocysteinuria
• Arachnodactyly is assessed by-

1. Ratio of Middle finger length to total hand length
2. METACARPAL INDEX - 

FINGER INDEX LENGTH/ WIDTH + MIDDLE L/W + RING L/W + LITTLE L/W DIVIDED BY 4 
METACARPAL INDEX > 8.4 SUGGESTS ARACHNODACTYLY 

Differential Diagnosis - Hypertelorism?

 Hypertelorism -Wide set eyes ie  when distance between two eyes more than the size of one eye

• Hurler's Syndrome
• Klippel- Feil Syndrome
• LEOPARD
• Noonan's Syndrome
• Turner's Syndrome
• William's Syndrome

Cafe eu' lait is seen in?

• Carney complex (LAMB and NAME Syndrome)

LAMB - Lentigines, Atrial Myxoma, Mucocutaneous Myxoma, Blue Naevi
NAME - Naevi, Atrial Myxoma, Myxoid Neurofibroma, Ephelides 

• LEOPARD - Lentigines, Electrocardiographic Abnormailties, Ocular hypertelorism, Pulmonary stenosis,Abnormal genitalia, Retarded growth, Deafness 
• Neurofibromatosis

 cafe eu lait pics http://www.dermis.net/dermisroot/en/37575/diagnose.htm

Differential Diagnosis - Micrognathia (llar to Hypognathia)

• Pierre Robin Syndrome
• Cri Du Chat Syndrome
• Fetal Alcohol Syndrome
• Rubenstein Tayabi Syndrome
• Trisomy 13-18
• Treacher Collins Syndrome
• Pyknodystosis

Differential Diagnosis - Cardio-Facial Syndrome ?

• CATCH-22
• CHARGE
• Down's Syndrome
• Goldenhar Syndrome(Oculo-auriculo-vertebral dysplasia)
• Noonan's Syndrome
• Pierre Robin Syndrome
• Shprintzen Syndrome
• William's Syndrome

Differential Diagnosis - Hypognathia

• Pierre Robin Syndrome
• Cri-du chat Syndrome
• Fetal Alcohol Syndrome
• Rubenstein Taybi Syndrome
• Trisomy 13,18
• Treacher Collins Syndrome
• Pyknodystosis

Mnemonic to remember causes of ACUTE PERICARDITIS

"TUMOR"
T - Trauma
U- Uremia
M- Myocardial Infarction, Medication
O - Other infections (bacterial, fungal)
R - Rheumatoid Arthritis, Radiation

Differential Diagnosis of Low pressure TR

1. Infective Endocarditis
2. Ebstein's anomaly
3. Right venrticular MI
4. Carcinoid
5. Tricuspid valve prolapse
6. Pacemaker
7. RV Endomyocardial fibrois
8. Loffler's
9. RA Myxoma
10. Trauma