April 24, 2025 • 12 mins
Poland syndrome: What is it? What causes it? How rare is it? In this episode, we will explore the history of Poland syndrome, what symptoms it can cause, and some of the treatment options available. Tune in to learn more!
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Resources:
Becca Butcher: https://www.instagram.com/beccabutcherx?igsh=MW9rNWw3eWVpbmx1Zw==
PIP-UK: https://pip-uk.org/
References:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8107865/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4410274/
https://medlineplus.gov/genetics/condition/poland-syndrome/
https://kidshealth.org/en/parents/poland-syndrome.html
https://rarediseases.org/rare-diseases/poland-syndrome/
https://pip-uk.org/poland-syndrome-ambassadors
https://www.imdb.com/name/nm0121400/trivia/
https://www.healthline.com/health/fun-facts-about-the-muscular-system
https://www.medicalnewstoday.com/articles/poland-syndrome
*This podcast is for entertainment purposes only. If you suspect you have a medical condition, please seek out an opinion of a medical professional.*
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
After giving birth to a beautiful boy named Max, you watch as the nurses carefully bring him to
(00:05):
you. He reaches out with his tiny right hand, and you can't help but feel a mix of awe and
confusion as you notice that his three middle fingers are so small, they almost seem to be
missing. Unsure if you're seeing things correctly, or if his hand truly appears to be that way,
you feel a wave of concern wash over you. Just when the moment feels like it stretches on forever,
(00:27):
the doctor approaches, asking to run some tests on your little one,
leaving you with a heavy heart and a flurry of thoughts about what might be ahead.
Hello and Welcome to Anatomy Of Illness. Today's episode is about Poland Syndrome.
(00:54):
Before we get into the condition,
we are going to
start with the history. So why do we know Poland Syndrome exists? We begin on the 11th of December
1803 with Citizen Marandel, who presented at a session of the Society of Anatomy of Paris.
Here he described a woman who had right-sided congenital mammary absence and muscular atrophy
(01:15):
on that side. So essentially the breast and muscle tissue on the right side of her chest were missing.
This had not been from a surgery or an accident, it was a condition she was born with. This would
be similar to future.
In 1839, we would see the observations of Froriep. They were the first to describe these missing
pectoral muscles along with webbed digits. So this is webbed fingers, essentially.
(01:40):
Now we move on to 1841, where we would meet our namesake doctor, Dr. Alfred Poland.
This is through an autopsy report on a 27-year-old man by the name of George Elt.
This was at Guy's Hospital in London. During this time, Dr. Poland was a student teacher of anatomy.
This autopsy report would be turned into a publication titled "Deficiency of the pectoral
(02:01):
muscles". In this, he would describe the case of George Elt. He wrote that Mr. Elt had no prior
history of illness, except he had an inability to draw his left arm across his chest. He also
would write about Elt having the muscles of his right arm being much more developed than his left.
The pectoralis major on the left side was smaller compared with the right,
and the pectoralis minor was missing on the left side. So the smaller chest muscle was missing. The
(02:27):
bigger one was still there, but smaller than the other. He also wrote about the thoracic blood
vessels, which is the blood vessels in the chest, being underdeveloped. The middle phalanges were
missing on all but the middle finger on the left hand. So this is the middle part of the bone in
the finger. However, in the autopsy report, there was no illustration of the arm or hand affected
(02:47):
by the condition. In the autopsy report, he had a drawing of the chest, which was done by an artist.
He also drew no conclusions to what could cause these,
or that they could be related. This has led to controversy surrounding whether or not the
condition should be named after him, as people believe that he did not know what was going on.
In 1895, Jon Thompson at the Royal Hospital for Sick Children in Edinburgh would write a report
(03:11):
called "On a Form of Congenital Thoracic Deformity". In this, he associated the abnormal
pectoral muscles with the hand being improperly developed. He built upon the understanding that
the hand deformities and the chest abnormalities were associated. In the year 1900,
Furst from Sweden would suggest that these chest symptoms and hand symptoms were actually a
syndrome. He would suggest “the two groups of malformations of the chest and of the hand are
(03:35):
so often present together that they must certainly stem from the same cause.” Furst also had suspicions
about where they arose from. “Both groups are embryonal and arise from the early embryonic time.”
Now we move to 1902 with Robert Bing, who did research on a series of 102 patients with pectoral
absence.
Of these, 14 had syndactylism, so a hand deformity of some sorts. He would note that,
(04:00):
“in the commonest muscle defect, that of the pectorals, there is, in the first place,
a clearly marked malformation of the hand, named syndactyly, with webbing and shortening of the
phalanges.” He also made comments about bony defects in the thorax often leading to lung
hernias, so the lung moving into a place it shouldn't be. This was also in association
(04:20):
with the abnormalities in the pectoral muscles, so this was also part of the condition.
In 1962, we would have Patrick Clarkson coin the term "Poland Syndactyly".
Dr Clarkson was a plastic and hand surgeon working at Guy's Hospital in London. Dr Clarkson had
requested to see the hand of Mr Elt that Dr Poland had previously. Dr Clarkson dissected Mr Elt's
(04:41):
hand and confirmed Dr Poland's writings. If you have been enjoying this episode,
don't forget to share it with a friend. It helps us grow.
What Causes Poland Syndrome?
Currently, there is no known cause for Poland syndrome. However, there are ideas that researchers
have suggested that may cause the condition. One of these ideas is that Poland syndrome is caused by
a disruption of blood flow during development before a person is born. This is thought to occur
(05:02):
around the six-week mark in embryonic development. This affects the blood vessels that will eventually
become the subclavian and vertebral arteries on each side of the body. These arteries normally
supply blood to the embryonic tissues that become the chest wall and hand on the affected side. So,
if the right side of the blood vessel is affected, this can lead to right hand and right chest wall
being affected. This may be caused by an abnormality in the blood flow during the development of the
condition. This may be caused by an abnormality in a developmental structure known as the apical
(05:25):
ectodermal ridge. This structure helps to direct early limb development and it may be involved in
the condition. However, there is no exact understanding of what causes this condition.
There are ideas about what may lead to it. In rare cases, there is thought to be a genetic
cause, so a change in the genetics, which leads to it being passed down in families. However,
(05:46):
there are no identified genes for Poland syndrome. And in the majority of cases, there is no family
history of the condition. In the inherited form, it is inherited in an autosomal dominant pattern,
so this is one copy from an affected parent leads to the child developing Poland syndrome. However,
again, in most cases of Poland syndrome, it is not inherited, it is spontaneous.
How common is Poland syndrome? Pollan syndrome is believed to occur in one in every 20,000
(06:11):
newborns, so it is a rare condition. However, this condition may be underdiagnosed,
as mild cases of Poland syndrome without hand involvement may never seek out medical attention.
As they may not realize they have the condition. Who is more likely to have Poland syndrome?
Poland syndrome occurs more in males. It occurs more than twice as often in men than in women.
(06:31):
However, the reason for this is unknown. Oh, hi, Mark. What's that? Check out Merch
Anatomy for the coolest new clothing. Thanks. Will do. How do we diagnose Poland syndrome?
Depending on the case of Poland syndrome will depend on what kinds of tests need to be done to
help with the diagnosis. However, the first step in diagnosis is normally a physical exam. This will
check over the affected area. In some cases, this is all that is needed for a diagnosis.
(06:55):
But there are often other tests that are run to get a better picture of what is going on.
These tests may include blood tests, chest x-rays, and CT scans. These are done to see
what is going on inside. Electrocardiograms, which is an EKG or an ECG. This tests the
electrical function of the heart, so it helps to see if the heart is affected. Pulmonary function
(07:15):
tests. This is to see if the lungs are affected. Genetic testing. Poland syndrome also has
related conditions. So this is to check for any related conditions as there are currently no
known genes causing Poland syndrome. We will get right into the symptoms and presentation right
after this little break. If you have been enjoying this episode, make sure you check
(07:44):
out our Buy Me A Coffee page. What symptoms might you have if you had Poland syndrome? The signs and
symptoms of Poland syndrome will really depend on the severity of the condition. For some, it will be
quite severe and will be noticed not long after they are born. For others, this condition will be
quite mild and may go unnoticed until puberty or may never get noticed. Everyone's signs and
symptoms will be different. However, with Poland syndrome, the effects of the condition are normally
(08:09):
only on one side of the body. So if it affects the left side of the chest and left hand or the right
side, rarely will it affect both sides. There is a debate on if it affects both sides, whether or not
it's Poland syndrome or a different condition altogether. But anyway, moving on. Some of the
symptoms that might occur with Poland syndrome include missing or underdeveloped chest and
shoulder muscles, abnormally placed or even missing armpit hair, abnormal ribs, these can
(08:34):
sometimes cause breathing issues, breast or nipple abnormalities, shortened forearm bones,
this is the radius and ulna, so the bones below the elbow, hand abnormalities,
this may be shortened or fused fingers, heart, lung, or kidney problems, every case is unique,
so everyone will have different symptoms when it comes to Poland syndrome.
What should a doctor be aware of when it comes to Poland syndrome?
(08:56):
Something a doctor should be aware of when it comes to Poland syndrome is that in rare but
severe occasions, it can affect the internal organs. More specifically, the lungs, kidney,
and heart. An example of one of these effects is dextrocardia. This is when the heart is located
on the right side of the chest rather than the left. It can also cause lung herniation, so the
lungs kind of being a little bit out of place. Again, these are rare. In most cases, Poland syndrome
(09:19):
has no effects on the internal organs, but these should still be checked and it should still be
monitored in case there is a potential side effect like lung herniation which can occur from time to
time. How do we treat Poland syndrome? Treatment for Poland syndrome will depend on what is affected
and to what extent it is affected. However, all treatment options for Poland syndrome do normally
involve some form of surgery. In many cases, people with Pollan syndrome will not need surgery as the
(09:44):
condition is not very noticeable. For the cases that do require surgery or do want surgery, what
surgical options are there for Poland syndrome? The surgical options for Poland syndrome include
implants or injections. These are done to fill out the chest cavity on the affected side. Hand
surgery. This is done to create a hand that is more useful. Again, not everyone will need this
as not everyone will have their hand affected. Surgery on the ribs. This is done to help with
(10:08):
any breathing issues Poland syndrome is causing. This is done in those whose ribs are affected by
the condition, which not everyone will have that. Are there any famous people with Poland syndrome?
He was a member of the 80s boy band Bros and has also starred in Dancing with the Stars. He was
originally not open with his diagnosis. However, now he uses his fame to help raise awareness of
(10:30):
the condition. If you would like to check out a social media page of someone who has Poland
syndrome, I recommend checking out Becca Butcher. She is a model, blogger, and content creator who
has Poland syndrome. On her Instagram, she shares a lot about Poland syndrome and is
incredibly informative, having videos explaining chest asymmetry and Poland syndrome. I recommend
checking her out. I will link her Instagram in the episode description. Although there are no media
(10:53):
representations I can recommend you to check out for Poland syndrome, I can give you a fun little
piece of trivia. I know, wild. I'm giving this before the after credits music. If you ever watched
the 1970s to 1980s sitcom M.A.S.H. and wondered why you never see the left hand of the character
Radar O'Reilly, it's because the actor who played him, Gary Burghoff, has Poland syndrome, which
(11:16):
affects his left hand. But anyway,
moving on. If you would like to check out a foundation for those in the UK, there is PIP UK.
They provide information for those living with Poland syndrome, allowing people with this
condition to better understand the condition and live better with it. They also raise awareness for
the condition and also provide a podcast to help provide more information on the condition. As
(11:36):
Poland syndrome is a rare condition, there are not really any other foundations for it. If you want
to check out the sources, social media links, or any other links, you can head to anatomyofillness.com.
If you enjoyed this episode and would like to hear more, subscribe to be notified
about our latest episodes. If you want to join our community,
you can join us on Discord or Instagram. Otherwise, stick around for the next episode.
Did you know your body has more than 600 muscles? These are divided into skeletal,
(12:13):
smooth, and cardiac. Skeletal muscles are muscles you control for movement. Cardiac
is responsible for the heart, and the smooth muscles are the involuntary muscles that are
responsible everywhere else, so like your digestive system and blood vessels.
After giving birth to a beautiful boy named Max, you watch as the nurses carefully bring him to
(00:05):
you. He reaches out with his tiny right hand, and you can't help but feel a mix of awe and
confusion as you notice that his three middle fingers are so small, they almost seem to be
missing. Unsure if you're seeing things correctly, or if his hand truly appears to be that way,
you feel a wave of concern wash over you. Just when the moment feels like it stretches on forever,
(00:27):
the doctor approaches, asking to run some tests on your little one,
leaving you with a heavy heart and a flurry of thoughts about what might be ahead.
Hello and Welcome to Anatomy Of Illness. Today's episode is about Poland Syndrome.
(00:54):
Before we get into the condition,
we are going to
start with the history. So why do we know Poland Syndrome exists? We begin on the 11th of December
1803 with Citizen Marandel, who presented at a session of the Society of Anatomy of Paris.
Here he described a woman who had right-sided congenital mammary absence and muscular atrophy
(01:15):
on that side. So essentially the breast and muscle tissue on the right side of her chest were missing.
This had not been from a surgery or an accident, it was a condition she was born with. This would
be similar to future.
In 1839, we would see the observations of Froriep. They were the first to describe these missing
pectoral muscles along with webbed digits. So this is webbed fingers, essentially.
(01:40):
Now we move on to 1841, where we would meet our namesake doctor, Dr. Alfred Poland.
This is through an autopsy report on a 27-year-old man by the name of George Elt.
This was at Guy's Hospital in London. During this time, Dr. Poland was a student teacher of anatomy.
This autopsy report would be turned into a publication titled "Deficiency of the pectoral
(02:01):
muscles". In this, he would describe the case of George Elt. He wrote that Mr. Elt had no prior
history of illness, except he had an inability to draw his left arm across his chest. He also
would write about Elt having the muscles of his right arm being much more developed than his left.
The pectoralis major on the left side was smaller compared with the right,
and the pectoralis minor was missing on the left side. So the smaller chest muscle was missing. The
(02:27):
bigger one was still there, but smaller than the other. He also wrote about the thoracic blood
vessels, which is the blood vessels in the chest, being underdeveloped. The middle phalanges were
missing on all but the middle finger on the left hand. So this is the middle part of the bone in
the finger. However, in the autopsy report, there was no illustration of the arm or hand affected
(02:47):
by the condition. In the autopsy report, he had a drawing of the chest, which was done by an artist.
He also drew no conclusions to what could cause these,
or that they could be related. This has led to controversy surrounding whether or not the
condition should be named after him, as people believe that he did not know what was going on.
In 1895, Jon Thompson at the Royal Hospital for Sick Children in Edinburgh would write a report
(03:11):
called "On a Form of Congenital Thoracic Deformity". In this, he associated the abnormal
pectoral muscles with the hand being improperly developed. He built upon the understanding that
the hand deformities and the chest abnormalities were associated. In the year 1900,
Furst from Sweden would suggest that these chest symptoms and hand symptoms were actually a
syndrome. He would suggest “the two groups of malformations of the chest and of the hand are
(03:35):
so often present together that they must certainly stem from the same cause.” Furst also had suspicions
about where they arose from. “Both groups are embryonal and arise from the early embryonic time.”
Now we move to 1902 with Robert Bing, who did research on a series of 102 patients with pectoral
absence.
Of these, 14 had syndactylism, so a hand deformity of some sorts. He would note that,
(04:00):
“in the commonest muscle defect, that of the pectorals, there is, in the first place,
a clearly marked malformation of the hand, named syndactyly, with webbing and shortening of the
phalanges.” He also made comments about bony defects in the thorax often leading to lung
hernias, so the lung moving into a place it shouldn't be. This was also in association
(04:20):
with the abnormalities in the pectoral muscles, so this was also part of the condition.
In 1962, we would have Patrick Clarkson coin the term "Poland Syndactyly".
Dr Clarkson was a plastic and hand surgeon working at Guy's Hospital in London. Dr Clarkson had
requested to see the hand of Mr Elt that Dr Poland had previously. Dr Clarkson dissected Mr Elt's
(04:41):
hand and confirmed Dr Poland's writings. If you have been enjoying this episode,
don't forget to share it with a friend. It helps us grow.
What Causes Poland Syndrome?
Currently, there is no known cause for Poland syndrome. However, there are ideas that researchers
have suggested that may cause the condition. One of these ideas is that Poland syndrome is caused by
a disruption of blood flow during development before a person is born. This is thought to occur
(05:02):
around the six-week mark in embryonic development. This affects the blood vessels that will eventually
become the subclavian and vertebral arteries on each side of the body. These arteries normally
supply blood to the embryonic tissues that become the chest wall and hand on the affected side. So,
if the right side of the blood vessel is affected, this can lead to right hand and right chest wall
being affected. This may be caused by an abnormality in the blood flow during the development of the
condition. This may be caused by an abnormality in a developmental structure known as the apical
(05:25):
ectodermal ridge. This structure helps to direct early limb development and it may be involved in
the condition. However, there is no exact understanding of what causes this condition.
There are ideas about what may lead to it. In rare cases, there is thought to be a genetic
cause, so a change in the genetics, which leads to it being passed down in families. However,
(05:46):
there are no identified genes for Poland syndrome. And in the majority of cases, there is no family
history of the condition. In the inherited form, it is inherited in an autosomal dominant pattern,
so this is one copy from an affected parent leads to the child developing Poland syndrome. However,
again, in most cases of Poland syndrome, it is not inherited, it is spontaneous.
How common is Poland syndrome? Pollan syndrome is believed to occur in one in every 20,000
(06:11):
newborns, so it is a rare condition. However, this condition may be underdiagnosed,
as mild cases of Poland syndrome without hand involvement may never seek out medical attention.
As they may not realize they have the condition. Who is more likely to have Poland syndrome?
Poland syndrome occurs more in males. It occurs more than twice as often in men than in women.
(06:31):
However, the reason for this is unknown. Oh, hi, Mark. What's that? Check out Merch
Anatomy for the coolest new clothing. Thanks. Will do. How do we diagnose Poland syndrome?
Depending on the case of Poland syndrome will depend on what kinds of tests need to be done to
help with the diagnosis. However, the first step in diagnosis is normally a physical exam. This will
check over the affected area. In some cases, this is all that is needed for a diagnosis.
(06:55):
But there are often other tests that are run to get a better picture of what is going on.
These tests may include blood tests, chest x-rays, and CT scans. These are done to see
what is going on inside. Electrocardiograms, which is an EKG or an ECG. This tests the
electrical function of the heart, so it helps to see if the heart is affected. Pulmonary function
(07:15):
tests. This is to see if the lungs are affected. Genetic testing. Poland syndrome also has
related conditions. So this is to check for any related conditions as there are currently no
known genes causing Poland syndrome. We will get right into the symptoms and presentation right
after this little break. If you have been enjoying this episode, make sure you check
(07:44):
out our Buy Me A Coffee page. What symptoms might you have if you had Poland syndrome? The signs and
symptoms of Poland syndrome will really depend on the severity of the condition. For some, it will be
quite severe and will be noticed not long after they are born. For others, this condition will be
quite mild and may go unnoticed until puberty or may never get noticed. Everyone's signs and
symptoms will be different. However, with Poland syndrome, the effects of the condition are normally
(08:09):
only on one side of the body. So if it affects the left side of the chest and left hand or the right
side, rarely will it affect both sides. There is a debate on if it affects both sides, whether or not
it's Poland syndrome or a different condition altogether. But anyway, moving on. Some of the
symptoms that might occur with Poland syndrome include missing or underdeveloped chest and
shoulder muscles, abnormally placed or even missing armpit hair, abnormal ribs, these can
(08:34):
sometimes cause breathing issues, breast or nipple abnormalities, shortened forearm bones,
this is the radius and ulna, so the bones below the elbow, hand abnormalities,
this may be shortened or fused fingers, heart, lung, or kidney problems, every case is unique,
so everyone will have different symptoms when it comes to Poland syndrome.
What should a doctor be aware of when it comes to Poland syndrome?
(08:56):
Something a doctor should be aware of when it comes to Poland syndrome is that in rare but
severe occasions, it can affect the internal organs. More specifically, the lungs, kidney,
and heart. An example of one of these effects is dextrocardia. This is when the heart is located
on the right side of the chest rather than the left. It can also cause lung herniation, so the
lungs kind of being a little bit out of place. Again, these are rare. In most cases, Poland syndrome
(09:19):
has no effects on the internal organs, but these should still be checked and it should still be
monitored in case there is a potential side effect like lung herniation which can occur from time to
time. How do we treat Poland syndrome? Treatment for Poland syndrome will depend on what is affected
and to what extent it is affected. However, all treatment options for Poland syndrome do normally
involve some form of surgery. In many cases, people with Pollan syndrome will not need surgery as the
(09:44):
condition is not very noticeable. For the cases that do require surgery or do want surgery, what
surgical options are there for Poland syndrome? The surgical options for Poland syndrome include
implants or injections. These are done to fill out the chest cavity on the affected side. Hand
surgery. This is done to create a hand that is more useful. Again, not everyone will need this
as not everyone will have their hand affected. Surgery on the ribs. This is done to help with
(10:08):
any breathing issues Poland syndrome is causing. This is done in those whose ribs are affected by
the condition, which not everyone will have that. Are there any famous people with Poland syndrome?
He was a member of the 80s boy band Bros and has also starred in Dancing with the Stars. He was
originally not open with his diagnosis. However, now he uses his fame to help raise awareness of
(10:30):
the condition. If you would like to check out a social media page of someone who has Poland
syndrome, I recommend checking out Becca Butcher. She is a model, blogger, and content creator who
has Poland syndrome. On her Instagram, she shares a lot about Poland syndrome and is
incredibly informative, having videos explaining chest asymmetry and Poland syndrome. I recommend
checking her out. I will link her Instagram in the episode description. Although there are no media
(10:53):
representations I can recommend you to check out for Poland syndrome, I can give you a fun little
piece of trivia. I know, wild. I'm giving this before the after credits music. If you ever watched
the 1970s to 1980s sitcom M.A.S.H. and wondered why you never see the left hand of the character
Radar O'Reilly, it's because the actor who played him, Gary Burghoff, has Poland syndrome, which
(11:16):
affects his left hand. But anyway,
moving on. If you would like to check out a foundation for those in the UK, there is PIP UK.
They provide information for those living with Poland syndrome, allowing people with this
condition to better understand the condition and live better with it. They also raise awareness for
the condition and also provide a podcast to help provide more information on the condition. As
(11:36):
Poland syndrome is a rare condition, there are not really any other foundations for it. If you want
to check out the sources, social media links, or any other links, you can head to anatomyofillness.com.
If you enjoyed this episode and would like to hear more, subscribe to be notified
about our latest episodes. If you want to join our community,
you can join us on Discord or Instagram. Otherwise, stick around for the next episode.
Did you know your body has more than 600 muscles? These are divided into skeletal,
(12:13):
smooth, and cardiac. Skeletal muscles are muscles you control for movement. Cardiac
is responsible for the heart, and the smooth muscles are the involuntary muscles that are
responsible everywhere else, so like your digestive system and blood vessels.
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