A 27-year-old man came with tall stature and prominent jaw since nine years
There is hyperpneumatisation of the frontal, the ethmoidal and maxillary sinuses and of the mastoid air cells. The skull vault is thickened. The external occipital protuberance is prominent. THe sella is large. There is prognathism.
The heel pad is thickened. The knee joints show asymmetrical joint space narrowing (medial > lateral) . The terminal phalanges are spade shaped.