Musculoskeletal abnormalities in a large international cohort of boys with 49,XXXXY

Am J Med Genet A. 2021 Dec;185(12):3531-3540. doi: 10.1002/ajmg.a.61578. Epub 2020 Apr 3.

Abstract

49,XXXXY is the rarest X and Y chromosomal variation, with an incidence of 1 in 80,000-100,000 live male births and has been associated with numerous musculoskeletal abnormalities. Data was collected from an international cohort of boys with 49,XXXXY over 10 years. Children were evaluated by a multidisciplinary team consisting of a pediatric orthopedist, a neurogeneticist, a neurodevelopmentalist, and two physical therapists. Increased rates of torticollis (32.4%), hamstring tightness (42%), radioulnar synostosis (67.6%), pes planus (65.2%), and other foot abnormalities (86.9%) were observed. Several anomalies increased with age, specifically hamstring tightness, kyphosis, and scoliosis. The elucidation of the orthopedic profile of this population is necessary in order to provide healthcare providers with current medical information. This research further supports the necessity for the comprehensive multidisciplinary treatment of boys with 49,XXXXY.

Keywords: 49,XXXXY; X and Y chromosomal variations; musculoskeletal health; orthopedics; physical therapy; sex chromosome abnormalities and aneuploidies.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Chromosomes, Human, X / genetics*
  • Chromosomes, Human, Y
  • Flatfoot / complications
  • Flatfoot / diagnosis
  • Flatfoot / genetics
  • Flatfoot / physiopathology
  • Hamstring Tendons / diagnostic imaging
  • Hamstring Tendons / physiopathology
  • Humans
  • Infant
  • Klinefelter Syndrome / complications
  • Klinefelter Syndrome / diagnosis*
  • Klinefelter Syndrome / genetics
  • Klinefelter Syndrome / physiopathology
  • Kyphosis / complications
  • Kyphosis / diagnosis
  • Kyphosis / genetics
  • Kyphosis / physiopathology
  • Male
  • Musculoskeletal Abnormalities / complications
  • Musculoskeletal Abnormalities / diagnosis*
  • Musculoskeletal Abnormalities / genetics
  • Musculoskeletal Abnormalities / physiopathology
  • Radius / abnormalities
  • Radius / physiopathology
  • Rare Diseases / complications
  • Rare Diseases / diagnosis*
  • Rare Diseases / genetics
  • Rare Diseases / physiopathology
  • Scoliosis / complications
  • Scoliosis / diagnosis
  • Scoliosis / genetics
  • Scoliosis / physiopathology
  • Synostosis / complications
  • Synostosis / diagnosis
  • Synostosis / genetics
  • Synostosis / physiopathology
  • Torticollis / complications
  • Torticollis / diagnosis
  • Torticollis / genetics
  • Torticollis / physiopathology
  • Ulna / abnormalities
  • Ulna / physiopathology

Supplementary concepts

  • Radioulnar Synostosis