Case of Dr 

This is a 49 year old farmer with a diagnosis of nail patella syndrome, a rare genetic condition that can cause problems with nails, bones, kidneys and eyes. It is estimated to occur in one in 50,000 people. The patient's son is also affected, but the nails are not so malformed. He does, however, have a very marked scoliolis which has required a brace for the past 3 years.

To be noted in this gentleman's photographs are the deformed nails and the small eccentric patellae.

View this other well illustrated case

http://www.nhs.uk/conditions/nail-patella-syndrome/Pages/Introduction.aspx