The Miller-McKusick-Malvaux (3M) syndrome (OHIM #273750) is a rare autosomal recessive disease characterized by severe intrauterine and postnatal growth retardation with dysmorphic facial features called gloomy face, and skeletal abnormalities.

(a)	(b)
Fig. 1. Dysomorphic features in a child with 3M syndrome. (a) Triangle-shaped face with frontal bumps, hypoplastic midface, provided eyebrows, an upturned nose with a fleshy tip, long philtrum, full lips and a pointed chin; (b) Frontal bumps, upturned nose and long phitru.

The characteristic features, present at birth are: a relatively large head, dolichocephaly, frontal bumps (Fig. 1 a and b), a triangular face, a pointed chin (Fig. 1 a), an up-turned nose, full lips, provided eyebrows, a long philtrum, and malar hypoplasia (Fig. 1 a). Skeletal abnormalities include short neck, prominent trapezius, square shoulders, short thorax, pectus excavatum, hyperlordosis,very flexible joints, short fifth finger (Fig. 2 a) and short and prominent heels (Fig. 2 b) which are almost pathognomonic of the syndrome.

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Fig. 2 Short fifth finger (a), and short prominent heels (b) in a child with 3M syndrome.