Among the suggested findings is short stature, because some of the diseases in the differential diagnosis include short stature. The boy was not short. In achondroplasia, the #1 disease, patients would already be short. Adding this pertinent negative makes achondroplasia go away. Similarly, macrocephaly appears next, and adding it puts MPS I (Hurler syndrome) as #1 as shown here (Onsets are crucial - kids with MPS I are all short, but not by 8 months). Corneal clouding is now the most useful finding, and when it is specified, the diagnosis of Hurler syndrome will become far more likely than shown here without it.