Which condition presents with multiple joint contractures at birth?

• A. Autosomal dominant
• B. Autosomal recessive
• C. Sex-linked dominant
• D. X-linked recessive

Answer: (A)

Congenital multiple joint contractures (arthrogryposis) are often seen in inherited conditions, and many of the autosomal dominant forms can present with contractures at birth. In autosomal dominant inheritance, a single mutated allele is enough to produce the phenotype, so affected individuals can appear in every generation and pass the trait to their offspring. This pattern fits best with a congenital presentation where one mutated gene can lead to the characteristic joint contractures seen at birth, as seen in disorders such as certain distal arthroplasia syndromes (for example, Freeman-Sheldon–type presentations).

Autosomal recessive and X-linked patterns would require two mutated copies or a sex-linked transmission that typically shows different family patterns (often affecting siblings more than parents, or a male-predominant pattern), which is less consistent with a straightforward birth-onset contracture picture. Therefore autosomal dominant inheritance is the most fitting explanation for a condition presenting with multiple joint contractures at birth.