Acromicric dysplasia is a rare bone dysplasia characterised by short stature, 
short hands and feet, normal intelligence, mild facial dysmorphism, and 
characteristic x ray abnormalities of the hands. Only a very small number of 
children with this condition have been reported so far. Here we report on a 
series of 22 patients including 10 boys and 12 girls with acromicric dysplasia. 
Length was normal at birth and height fell progressively off the centiles 
postnatally. The mean adult height was 130 cm (133 cm in males, 129 cm in 
females). The hands, feet, and limbs were short and OFC was normal. Intelligence 
was normal and mild dysmorphic features were noted. Other occasional features 
included well developed muscles, a hoarse voice, generalised joint limitation in 
some patients, frequent ear, tracheal, and respiratory complication, and spine 
abnormalities. Long term follow up showed that facial dysmorphism was less 
obvious in adults and that carpal tunnel syndrome was frequent in older 
patients. Apart from short metacarpals and phalanges, internal notch of the 
second metacarpal, external notch of the fifth metacarpal, and internal notch of 
the femoral heads, there were no major x ray abnormalities. No major 
complications, such as cardiac disease or major orthopaedic problems, occurred 
in the course of the disease. The condition appeared to be sporadic in 16 cases 
but the observation of vertical transmission in three families was consistent 
with an autosomal dominant mode of inheritance.