The skeletal dysplasias are a large heterogeneous group of genetic conditio
ns characterized by abnormal shape, growth, or integrity of bones. Often, t
here may be prominent features associated with other organ systems as part
of a more encompassing skeletal malformation syndrome. Tremendous advances
have been made in the clinical and molecular delineation of these condition
s over the past 20-30 years. We have progressed from initial broad clinical
classifications of these conditions in the first two-thirds of this centur
y, to extensive delineation based on radiographic features in the 1970s and
1980s, to the present reconsideration and grouping of these conditions acc
ording to their molecular pathogenesis. This has in part been spurred on by
advances in the understanding of the developmental pathways which govern s
keletal development, as well as by the human genome sequencing effort, whic
h has provided a plethora of positional candidate genes for many of these c
onditions. The pathogenetic correlations derived from such studies are ofte
n based on parallels between the human phenotype and mouse models of the hu
man condition, and have sometimes revealed novel developmental functions.