The congenital absence or fusion of interphalangeal joints was named symphalangism by Dr. Harvey Cushing in 1916 (1). This article adds a further case to the American literature, with associated fusions of the tarsal bones. A twenty-year-old soldier was examined because of pain in the proximal interphalangeal joint of the right middle finger. He exhibited complete immobility of proximal interphalangeal joints of the third, fourth, and fifth fingers of the left hand and similar findings in the right hand, except for partial motion (approximately 40 per cent) in the joint of the middle finger. Figure 1 shows the appearance of the hands when the patient attempted to double them into fists. Roentgenograms are reproduced in Figure 2. The patient stated that he had six stiff fingers until the age of nineteen, when some motion developed in the joint of the right middle finger. He had been inducted into the Army, though with some hesitancy on the part of the examiner, and had been able to do full duty as a truck driver, without complaint. He was a good basketball player, but had recently “bumped” his right middle finger, causing some pain and swelling in the joint. It was because of this that he presented himself for examination. Roentgenograms were made of the entire skeletal system. The only additional findings of significance were in the feet (Fig. 3), consisting in symphalangism of the distal interphalangeal joints of the third, fourth, and fifth toes bilaterally and fusion of the talus and navicular, and of the calcaneus and cuboid, also bilaterally. The patient stated that the hands of his older brother, mother, maternal uncle, and maternal grandfather were affected in the same manner as his own. The latter three were deceased, but a trip was made to the patient's home in West Virginia to see the brother and obtain roentgenograms. The findings were about the same as in the original patient, with variations only in degree. The brother had served thirty months in the Navy and gave a history of some pain in the ankles on prolonged standing. He stated, further, that he was unable to grasp the ropes on the sides of the ship firmly enough to hold his weight, unless a knot was made. The mother was said to have been adept at sewing in spite of her stiff fingers. French authors apparently were the first to describe hereditary ankylosis of phalangeal joints—Mercier (2) in 1838 and Moutard-Martin and Pissavy in 1895 (3). According to O'Donoghue and Sell (4), Anderson in 1879 was the first to discover talonavicular synostosis, during dissection of a cadaver. In 1901, Walker (5) described a family resident in Virginia, with varying degrees of ankylosis and actual absence of the phalanges. Dr. Harvey Cushing, as stated above, named the condition symphalangism in 1916. He studied a large family that came originally from Scotland in 1700 and settled in Virginia.