The incidence and the meaning of the metacarpal pseudoepiphysis (PE) found in the hand X-rays of mentally retarded children has yet to be clearly determined. Statistical analysis of examinations of 67 Down's children, 378 non-Down retarded children and 478 normal children with ages ranging from 2 to 9 showed;
(a) high incidence of PE among the retarded, 48% in Down's, 16% in non-Down's and less than 3% in normal children;
(b) extreme male dominance of PE holders except for Down's;
(c) high complications of multiple minor anomalies in PE holders;
(d) high occurrence of first or only child in the PE holding retarded;
(e) high incidence of late ambulation and speaking, quiet passive behaviors in PE holding retardedz
(f) high occurrence of β activity in EEG of PE holding retarded.
Several transferring cases are found among the three groups. For examples, one mosaic Down's syndrome without clinical stigmata is found among the PE holders and several students with borderline IQ are seen among the normal PE holders.
Thus, this study supports the position that pseudoepiphysis can be a stigmata of mental retardation or developmental aberration and should be included in developmental diagnosis.
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