{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-13T23:45:34Z", "providers": [ "Claude" ], "breadth": "written by Claude from model knowledge without web access - no source was read, every claim is a lead to verify", "pass": 2, "wave": 4, "engine": "claude", "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T11:00:00Z", "ingestedAt": "2026-10-06T07:41:49+00:00", "fields": [ "agent_conduct", "ethics", "owners" ] }, "revisions": [ { "at": "2026-10-06T22:42:57+00:00", "engine": "codex", "fields": [ "definition", "visual_identification" ], "answering_review": "4f92352cb7fd6e8352541eb591b027475aca319b363c3d8029b55045ddda1bd2" } ], "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T10:10:28+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "2 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q2141048", "registryId": "vr.tr.synostosis", "name": "synostosis", "version": "0.2.0-wave.4", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q2141048/", "model": { "registry_id": "vr.tr.synostosis", "name": "synostosis", "purpose": "Let an agent explain synostosis in general terms, relay types, causes, signs, diagnosis and treatment approaches from orthopaedic, craniofacial and genetics sources, point families to specialists and route signs of raised intracranial pressure in infants to urgent care, describe the named forms and syndromes, and distinguish synostosis from normal ossification, arthrodesis as surgical fusion, ankylosis and synovitis, without diagnosing individuals.", "definition": "An abnormal bony fusion of two or more bones that are normally separate, present from birth or acquired, including craniosynostosis, early fusion of skull sutures that can affect head shape and brain growth, radioulnar synostosis limiting forearm rotation, metacarpal synostosis in the hand, and bony tarsal coalitions in the foot such as talocalcaneal, talonavicular and calcaneonavicular coalitions, which may cause stiff, painful flat feet in adolescence; fibrous and cartilaginous tarsal coalitions are not synostoses. Syndromes the registry aliases name include spondylocarpotarsal synostosis syndrome and a radioulnar synostosis syndrome with developmental delay and hypotonia. Treatment ranges from observation and orthoses to surgery, under specialist care.", "what_it_is_for": "Not applicable; a bone development condition.", "affordances": [ "explain types and causes", "relay diagnosis and treatment approaches", "describe named forms and syndromes", "point to specialists" ], "distinguishing_features": [ "Bone fusion", "Congenital or acquired", "Site-specific effects", "Syndromic associations" ], "appearance": "May show unusual head shape, limited forearm rotation, stiff flat feet or fused bones on imaging.", "visual_identification": [ "Synostosis is abnormal bony fusion of separate bones.", "Examples include metacarpal synostosis, spondylocarpotarsal synostosis syndrome, radioulnar synostosis syndrome, and tarsal coalitions such as talonavicular and calcaneonavicular coalitions when the union is bony.", "Fibrous and cartilaginous tarsal coalitions are not synostoses.", "Normal ossification fuses growth plates on schedule; arthrodesis is surgical fusion; ankylosis is joint stiffening; synovitis is joint lining inflammation." ], "physical_properties": [ { "quantity": "craniosynostosis incidence", "typical_range": "about 1 in 2,000-2,500 births", "unit": "note", "note": "estimates vary" }, { "quantity": "tarsal coalition prevalence", "typical_range": "about 1-2 percent", "unit": "note", "note": "estimates vary" }, { "quantity": "registry parent", "typical_range": "dysostosis", "unit": "note", "note": "" } ], "families_and_kinds": [ "craniosynostosis", "radioulnar synostosis", "carpal and metacarpal synostosis", "tarsal coalitions", "syndromic synostoses" ], "related_models": [ { "relation": "is a kind of", "target": "dysostosis", "why": "in registry terms" }, { "relation": "includes", "target": "craniosynostosis", "why": "" }, { "relation": "includes", "target": "tarsal coalition", "why": "" }, { "relation": "is contrasted with", "target": "arthrodesis", "why": "" } ], "identifiers": [], "standards_and_regulation": [ "Craniofacial and paediatric orthopaedic guidelines", "Genetic testing and counselling standards" ], "failure_modes_and_hazards": [ "Missing raised intracranial pressure in infants", "Diagnosing individuals", "Delayed specialist referral" ], "in_scope": [], "out_of_scope": [], "characteristics": [], "agent_conduct": { "may": [ "Explain types of synostosis, such as craniosynostosis and radioulnar synostosis, in general terms.", "Help families find specialist services and prepare questions for clinicians." ], "must_not": [ "Diagnose synostosis from photos or describe a child's head shape as abnormal without clinical assessment.", "Advise for or against surgery for a specific child.", "Share images or medical details of a child with the condition without parental consent." ], "requires_human": [ "Any decision about surgery or treatment." ] }, "ethics": { "considerations": [ "Many affected patients are infants, and decisions about surgery fall to worried parents.", "Visible differences can bring stigma that respectful language helps avoid." ], "affected_parties": [ "Children with the condition", "Parents and families" ] }, "owners": { "steward": "The patient's treating clinicians and, for a child, the parents or guardians.", "master_systems": [] } }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q2141048: synostosis", "url": "https://www.wikidata.org/wiki/Q2141048", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Synostosis", "url": "https://en.wikipedia.org/wiki/Synostosis", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "understand", "name": "Understand", "description": "What synostosis is.", "rationale": "Science.", "layers": [ { "id": "definition", "name": "Definition", "description": "Definition.", "findings": [ { "id": "definition-finding", "name": "Definition", "description": "Definition.", "questions": [ { "text": "Does an infant have a bulging soft spot, persistent vomiting, unusual sleepiness or rapidly changing head shape, in which case seek urgent medical assessment?", "kind": "boundary" }, { "text": "What is synostosis, and how does it differ from normal ossification, arthrodesis, ankylosis and synovitis?", "kind": "definition" } ] } ] }, { "id": "forms", "name": "Forms", "description": "Named forms.", "findings": [ { "id": "forms-finding", "name": "Forms", "description": "Forms.", "questions": [ { "text": "What are tarsal, talonavicular and calcaneonavicular coalitions, metacarpal synostosis and the named syndromes?", "kind": "definition" }, { "text": "Which entry fits the specific form?", "kind": "action" } ] } ] } ] }, { "id": "medicine", "name": "Medicine", "description": "Causes and diagnosis.", "rationale": "Science.", "layers": [ { "id": "causes", "name": "Causes", "description": "Causes.", "findings": [ { "id": "causes-finding", "name": "Causes", "description": "Causes.", "questions": [ { "text": "What genetic and developmental causes are known, such as FGFR mutations in craniosynostosis?", "kind": "provenance" }, { "text": "Which references are standard?", "kind": "provenance" } ] } ] }, { "id": "imaging", "name": "Imaging", "description": "Imaging.", "findings": [ { "id": "imaging-finding", "name": "Imaging", "description": "Imaging.", "questions": [ { "text": "How do X-rays, CT and MRI identify fusions, in general terms?", "kind": "provenance" }, { "text": "Which sources are cited?", "kind": "provenance" } ] } ] } ] }, { "id": "care", "name": "Care", "description": "Treatment.", "rationale": "Regulation.", "layers": [ { "id": "skull", "name": "Skull", "description": "Craniosynostosis care.", "findings": [ { "id": "skull-finding", "name": "Skull", "description": "Skull.", "questions": [ { "text": "What surgical approaches treat craniosynostosis, in general terms?", "kind": "provenance" }, { "text": "Which entry fits cranial vault remodelling?", "kind": "action" } ] } ] }, { "id": "feet", "name": "Feet", "description": "Tarsal coalition care.", "findings": [ { "id": "feet-finding", "name": "Feet", "description": "Feet.", "questions": [ { "text": "How are painful tarsal coalitions managed with orthoses or surgery?", "kind": "provenance" }, { "text": "Which entry fits flat feet?", "kind": "action" } ] } ] } ] }, { "id": "context", "name": "Context", "description": "Families.", "rationale": "Context.", "layers": [ { "id": "genetics", "name": "Genetics", "description": "Genetic counselling.", "findings": [ { "id": "genetics-finding", "name": "Genetics", "description": "Genetics.", "questions": [ { "text": "When is genetic counselling offered for syndromic synostosis?", "kind": "provenance" }, { "text": "Which entry fits genetic counseling?", "kind": "action" } ] } ] }, { "id": "support", "name": "Support", "description": "Support groups.", "findings": [ { "id": "support-finding", "name": "Support", "description": "Support.", "questions": [ { "text": "Which organisations support families affected by craniofacial conditions?", "kind": "provenance" }, { "text": "Is the information current?", "kind": "boundary" } ] } ] } ] } ] }, "openQuestions": [ "Should tarsal coalition be a separate entry?", "Should syndromes be moved to their own entries?", "How should craniofacial guidelines be linked?" ], "statistics": { "bundles": 4, "layers": 8, "findings": 8, "questions": 16 } }