Fig. 1

a The first row includes images from the skeletal survey performed at age 7 months, which show brachycephaly, mild midface hypoplasia, right distal femoral and proximal tibial coned epiphyses, brachydactyly, and advanced bone age with ossification of the carpal and tarsal bones. b: The second row includes images obtained at age 33 months, demonstrating the significant progression of midface hypoplasia, brachycephaly, and cone shaped epiphysis in the right knee, brachydactyly, and advanced bone age