Carefully review the history, especially:
● Family history
● Pregnancy
● Perinatal history
Note abnormalities on other parts of the physical examination, especially:
● Growth
● Development
● Other dysmorphic somatic features
Perform measurements (and plot percentiles), especially:
● Head circumference
● Height
● Weight
Consider the three mechanisms of facial dysmorphogenesis:
● Deformations from intrauterine constraint
● Disruptions from amniotic bands or fetal tissue
● Malformations from intrinsic abnormality in face/head or brain
Examine the parents and siblings:
● Similarity to a parent may be reassuring (e.g., large head) but may also be an indication of a familial disorder
Try to determine whether the facial features fit a recognizable syndrome, comparing with:
● References (including measurements) and pictures of syndromes
● Tables/databases of combinations of features
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