A distinct “Harlequin hat” or “Dutch Wooden shoe” appearance of the distal femoral epiphyses, characterized by a triangular shape with thinning at the lateral sides, serves as a significant indicator for MATN3-related MED; however, this phenotype was not observed in our patients [2, 8, 26]. This evidence concerns the gene MATN3 and multiple epiphyseal dysplasia.