This Hand Radiograph of a 2 year old Child with Dwarfism suggest the diagnosis of:

The Hand Radiograph demonstrates widening of metacarpals with proximal pointing of metacarpals from index to little finger suggestive of Moriquos syndrome an autosomal recessive Mucopolysaccharoidosis type IV. Proximal pointing of metacarpals is also a feature of Hurlers syndrome another autosomal recessive Mucopolysaccharoidosis type-I.