Bone and Joint Health
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Infants with TS have an increased risk of congenital hip dislocation (which increases the risk of osteoarthritis in the hips of older women).
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The lower jaw bone may be quite small and contribute to orthodontic issues
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10% of girls with TS develop scoliosis (curvature of the spine) during early childhood or adolescence. Scoliosis also may become apparent or worsen during growth spurts related to GH treatment. The pediatric endocrinologist will check for these conditions at regular clinic visits and refer to a specialist if needed.
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The bones in the hands and wrist may be particularly affected and a few have bowing of the forearm and deformity of the wrist (Madelung deformity).
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There may also be changes in the knees which give a knocked-knee appearance.
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Those with TS may appear stocky due to relatively broad shoulders and pelvis.
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Proper estrogen treatment (ovarian hormone replacement) improves BMD and helps protect bones and adequate calcium and vitamin D intake is essential.
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In rare cases the hip(s) can be dislocated at birth or the top of the hip bone can slip off the long-bone during later years of growth (slipped capital femoral epiphysis).
