 There have been several orthopedic concerns identified in individuals with 18p-.These include pes planus, clubfoot, scoliosis and/or kyphosis, pectus abnormalities, cubitus valgus, congenital hip dysplasia, spina bifida occulta, and genu valgum.Growth hormone deficiency has been reported in several individuals with 18p-, though not at the same frequency as in the distal 18q- population.