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September 1987

Minor MalformationsSignificant or Insignificant?

Am J Dis Child. 1987;141(9):947. doi:10.1001/archpedi.1987.04460090024014

It is of the highest importance in the art of detection to be able to recognise out of a number of facts which are incidental and Which are vital. Otherwise your energy and attention must be dissipated instead of being concentrated.

Sherlock Holmes

Two articles in this issue address the question of the clinical significance of the presence of a minor malformation—in this instance, a supernumerary nipple. Like Sherlock Holmes, the pediatrician must be able to recognize the significance or insignificance of minor congenital anomalies (or as Pinsky1 termed them, informative morphogenetic variants) to concentrate rather than dissipate his/her diagnostic "energy."

See also pp 987 and 989.

A minor congenital anomaly may be defined as an unusual morphologic feature found in less than 4% of the general population that is of no serious medical or cosmetic significance to the affected individual.2 A minor anomaly may be a malformation (a

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