Common signs are short neck, impaired movement of the head and neck especially from side to side and a low hairline at the back of the neck and low-set or underdeveloped ears. The extent to which individuals are affected by these features can vary widely, ranging from mild cosmetic concerns to more severe impairment.Those with more severe problems tend to present earlier in life.
Other features associated with Klippel-Feil syndrome include: scoliosis; spina bifida occulta, an extremely mild form of spina bifida; one shoulder blade higher than the other (sprengel deformity of the shoulder); kidney and urinary tract problems; cleft palate (see entry Cleft Lip and/or Palate); fusion of two or more ribs; problems with movements including when one side of the body is moved, the other side wanting to do exactly the same (otherwise known as mirror movements); and hearing problems (see entry Deafness). Sometimes the larynx (voice box) can be involved causing problems with vocalising.
Patients may present with symptoms at any age and therefore a diagnosis may not be made until later in life. Diagnosis is made clinically on examination of the patient, in conjunction with the specific X-ray findings. Typically, these involve at least two of the seven bones in the neck (otherwise known as the cervical vertebrae) being joined together or fused. Fusion or anomalies of vertebrae in the thoracic (chest area) or lower back may also be seen in Klippel-Feil syndrome.
Klippel-Feil syndrome is associated with conditions including MURCS Association and Wildervanck syndrome.
Only females are affected with MURCS Association. In this condition the Klippel-Feil anomaly is associated with kidney abnormality and underdevelopment of the female reproductive organs, the uterus, fallopian tubes and vagina. The problems may range from very mild, in which all the organs are present but the uterus may be slightly small or an unusual shape, to more severe when the uterus and tubes may be completely absent. Sometimes, there may actually be a double uterus and vagina. MURCS may be found to be the problem when a woman has fertility problems.
Wildervanck syndrome is also more likely to be found in females than males. The Klippel-Feil anomaly is associated with sensorineural (nerve) deafness and eye problems so that there is a squint with the eyes looking inwards. This specific eye problem associated with Wildervanck syndrome is known as duane retraction syndrome.