Cloverleaf Skull and Bone Dysplasias (Report of four cases)

SUMMARY Four newborns with cloverleaf skull – one with elbow synostoses, one with thanatophoric dysplasia and two with a generalised bone dysplasia are reported. The syndromic relationship of cloverleaf skull deformity is discussed, specifically that between cloverleaf deformity with thanatophoric dysplasia and cloverleaf deformity with generalised bone dysplasia which is different from both achondroplasia and thanatophoric dysplasia. The diagnosis “thanatophoric dysplasia with cloverleaf deformity” should be strictly applied to the rare cases of cloverleaf skull which show generalised bone changes characteristic for this syndrome. CLOVERLEAF SKULL (CS) is an easily recognised anomaly. Its associations with other skeletal anomalies is well known. There is however confusion between cases of CS with generalised bone dysplasias. The purpose of this paper is to clarify this latter problem as well as to report four new cases of this rare anomaly.