Patient's question:
What does a picture of Down syndrome in children look likeDoctor's answer:
The child exhibits obvious special facial and physical features, such as wide-set eyes, a low nasal bridge, small palpebral fissures, upward slanting outer corners of the eyes, epicanthal folds, small ears, a fat tongue that often protrudes outside the mouth, and excessive drooling. The child has short stature, a smaller head circumference than normal, a short anteroposterior head diameter, a flat occiput, and a flattened head. The neck is short with loose skin. Bone age is often delayed compared to chronological age, with delayed teething and frequent malpositioning. The hair is fine, soft, and sparse. The anterior fontanelle closes late, and a third fontanelle may be present along the midline of the parietal region. The limbs are short, and due to ligamentous laxity, the joints can be excessively flexible. The fingers are thick and short, and the middle phalanx of the little finger is underdeveloped, causing the little finger to bend inward. The phalanges are short, and the triradiate carpal point shifts distally. Common features include transverse palmar creases and sandal foot, with about half of the children having an arch-shaped palmar crease on the ball of the thumb.