September 1983

Proper Measurements in Physical Diagnosis

Author Affiliations

Department of Pediatrics Boston Floating Hospital for Infants and Children 171 Harrison Ave Boston, MA 02111

Am J Dis Child. 1983;137(9):828. doi:10.1001/archpedi.1983.02140350006002

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It is no longer acceptable to describe dysmorphic physical findings without using proper measurements. Claims, such as low-set ears, widespaced eyes, and long fingers, should not be made unless they are accompanied by accurate measurements. Incorrect clinical impressions, because of lack of measurements, have been responsible for persistent misinformation about specific syndromes. For example, many clinicians are still under the false impression that children with Turner's syndrome have wide-spaced nipples and an increased carrying angle. Studies using proper measurements have shown that these observations are not correct.

The method used to obtain clinical measurements varies. Direct measurements are more practical than measurements by radiologic examination because it allows the clinician to perform such measurements in the hospital and office setting. The only measurements that should be used are those that have a significant number of normal controls.

It is impossible for the physician in practice to be aware of the