short, tapered fingers - an almost universal characteristic, and seems to be the most reliable diagnostic feature in infancy.

tufting of the bones of the fingers and toes that are farthest to the outside of the body (tufting of distal phalanges - can only be seen on X-rays)

puffy hands

soft, elastic skin

hyperconvex nails (short, curved fingernails)

hypothenar crease (short, horizontal line in palm of hand below little finger)