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Most measurements showed substantial to perfect intra- and interobserver agreement. Still, we found a few outliers presumably caused by poorer signal quality in some tracings rather than being observer dependent. An improvement of analysis results may be achieved by using a standard analysis protocol, a standardized method for judging tracing quality, better training options for method users, and more interaction between investigators from different institutions.

The full-blown classical syndrome of KTS has a triad of congenital mesodermal abnormalities characterized by portwine stain, venous varicosities, and hypertrophy of soft tissue and/or overgrowth of bone of one or more limbs. 5 However, not all patients have exhibited the full triad. In a study by Gloviczki et al. 6 of 144 patients with KTS, portwine stain was present in 95% of cases, hypertrophy of the soft tissues or bones in 93%, and varicosities in 76%. Moreover, unusual variants of the syndrome are often described, such as limb hypotrophy. 3,4 KTS has recently been considered as the eponym applied to a condition of primarily capillary-venous vascular malformation associated with altered limb bulk and/or length. 7 In our patient, capillary malformation was associated with decreased bone length and thickness.

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