FINGERNAIL ANGLE IN GIRLS WITH ULLRICH-TURNER SYNDROME

Increased angle of insertion of the fingernails is known to be a commo n finding in girls with Ullrich-Turner syndrome (UTS), but there are f ew data on the frequency of this finding and no quantitative data that define what is a normal fingernail angle. To assess the usefulness of this measurement in evaluating patients with suspected UTS, we obtain ed tracings of 6 different fingernails to determine the mean fingernai l angle (MFA) in 40 patients with UTS and compared the results with co ntrol girls and adults. As a group, the 24 girls with 45,X had an aver age MFA of 8.9-degrees, compared to 6.8-degrees for the 16 mosaics and variants, 3.0-degrees for normal children and 1.3-degrees for normal adults. Although there was overlap between the groups, 79% of 45,X gir ls and 56% of variants had an MFA of >6-degrees, whereas only 8% of th e combined control individuals had an MFA of >6-degrees. Reproducibili ty of MFA determinations based on tracings obtained at consecutive vis its was excellent (r = 0.92). There was no clear correlation between t he MFA and the severity of the UTS phenotype. Determination of MFA is a simple, objective measurement which, when combined with other clinic al findings, may aid the clinician in making a diagnosis of UTS.