Signs and symptoms are typically present before the age of 20 and the condition is often under-recognized in adults.It affects males and females of all races and exhibits no inheritance pattern. The medical literature contains case reports from every continent.Because it is so rare, and commonly misdiagnosed, it is not known exactly how many people are affected by this disease. References
Further reading
Dellinger M. T., Garg N, Olsen B.R. (2014). "Viewpoints on vessels and vanishing bones in Gorham-Stout disease". Bone. 63C: 47–52. doi:10.1016/j.bone.2014.02.011. PMID 24583233. {{cite journal}}:  CS1 maint: multiple names: authors list (link)
Trenor C, Chaudry G (Aug 2014). "Complex lymphatic anomalies". Semin Pediatr Surg. 23 (4): 186–90. doi:10.1053/j.sempedsurg.2014.07.006. PMID 25241096. Lala S, Mulliken JB, Alomari AI, Fishman SJ, Kozakewich HP, Chaudry G (Jul 2013). "Gorham-Stout disease and generalized lymphatic anomaly—clinical, radiologic, and histologic differentiation". Skeletal Radiol. 42 (7): 917–24. doi:10.1007/s00256-012-1565-4. PMID 23371338. S2CID 22640055. {{cite journal}}:  CS1 maint: multiple names: authors list (link)
Those with this condition can have affected parents, but it can also manifest for the first time with no family history which is called de novo. Since Duane-radial ray syndrome is an autosomal dominant disorder, there is a 50% chance of passing the mutation on to offspring. Mechanism
The mechanism for this disorder is somewhat unclear. What is known is that Duane-radial ray syndrome begins with mutations in the SALL4 gene. Due to these mutations, the proteins involved in embryonic development for making tissues and organs are not functioning properly. These proteins then cause improper development of bones (e.g. absence of the radius), abnormal eye movements, and other miscellaneous symptoms. Diagnosis
The diagnosis for this syndrome is based on clinical findings on a physical exam and the presence of a heterozygous SALL4 pathogenic variant. During the physical exam, Duane-radial ray syndrome is clinically established by the following clinical findings:

Duane Anomaly
Limitation of abduction of the eye
Retraction of the globe
Narrowing of the palpebral fissure during adduction
Radial Ray Malformations
Malformed, absent, or extra thumb
A thumb that looks more like a finger
Duplication of the thumb (preaxial polydactyly)
Deformity of the arm due to a lack of the radius
Any of the symptoms above that can observed
Hearing loss
Clubfoot
Unusually shaped ears

Related conditions
The varied signs and symptoms of Duane-radial ray syndrome often overlap with features of other disorders. For example, acro-renal-ocular syndrome is characterized by Duane anomaly and other eye abnormalities, radial ray malformations, and kidney defects. Both conditions can be caused by mutations in the same gene.