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Living with Radioulnar synostosis-developmental delay-hypotonia syndrome

An extremely rare syndrome with a fused forearm, low muscle tone, and developmental delay.

Understanding Radioulnar synostosis-developmental delay-hypotonia syndrome

Radioulnar synostosis-developmental delay-hypotonia syndrome, also called Der Kaloustian-McIntosh-Silver syndrome, is an extremely rare syndrome described in about 4 people.

It involves a fused forearm bone joint on one side (radioulnar synostosis) present from birth, low muscle tone, and developmental delay. Facial features can include a long face, a prominent nose, and prominent ears. GARD lists onset in the newborn period.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Fused forearm bones
  • Low muscle tone (hypotonia)
  • Delays in development
  • Long, narrow head and prominent ears
  • Dental differences and cavities
  • Hearing and eye alignment differences

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include bone and joint specialists, brain and nervous system specialists, eye disease specialists and genetic specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

  4. Connect with expert centers

    World Craniofacial Foundation may keep lists of experts for this condition.

Care & treatment

Care team
Bone and joint specialists (orthopedists or orthopedic surgeons); Brain and nervous system specialists (neurologists); Eye disease specialists (ophthalmologists); Genetic specialists (geneticists)
Expert care
Expert lists: World Craniofacial Foundation
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with World Craniofacial Foundation and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Is genetic testing available to find the cause?
What therapies can help with muscle tone and development?
Should the kidneys, hearing, and eyes be checked?

Quick facts

Symptoms usually startNewborn

GARD says gene changes cause this condition. It doesn't name a gene or describe inheritance yet.

GeneticNeurological

Also known as: der kaloustian-mcintosh-silver syndrome; radioulnar synostosis with developmental delay and hypotonia syndrome

Patient organizations

Source: NIH GARD · Radioulnar synostosis-developmental delay-hypotonia syndromeGARD ID 1810 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Radioulnar synostosis-developmental delay-hypotonia syndrome.

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