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Book Reviews and Other Media
August 2008

Smith’s Recognizable Patterns of Human Deformation, 3rd ed

Author Affiliations


Arch Pediatr Adolesc Med. 2008;162(8):796. doi:10.1001/archpedi.162.8.796

by John M. Graham Jr, MD, ScD, 361 pp, $89, ISBN-13 978-0-7216-1489-2, Philadelphia, Pennsylvania, Saunders Elsevier, 2007.

In the current parlance of dysmorphology, deformations are normal tissue responses to unusual mechanical forces, and disruptions represent breakdown of previously normal tissues. These 2 categories are distinguished from malformations and dysplasias, which reflect primary errors in morphogenesis or tissue structure, respectively. This distinction of secondary from primary causes has fundamental implications for prognosis, prevention, recurrence risk, and clinical management. However, both categories can coexist in the same patient, since primary abnormalities can predispose organs, tissues, or body regions to deformation or disruption. Deformations are by no means limited to prenatal life, as abnormal mechanical forces often affect structure of the growing infant and child.

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