A young boy from nonconsanguineous Palestinian parents presented with short stature, motor developmental delay, wide nasal bridge, bilateral periorbital edema, everted lower lip, brachydactyly, large interphalangeal articulations, drumstick extremities of the fingers, bilateral simian crease, clinodactyly of the 5th fingers, painful joints, subcutaneous nodules all over his body and recurrent episodes of fever of unknown origin. Differential diagnoses such as the hyperimmunoglobulinemia D syndrome, tumor necrosis factor receptor associated periodic syndrome (TRAPS), the chronic infantile neurological cutaneous and articular (CINCA) syndrome, and the newly recognized nodulosis, arthropathy, and osteolysis (NAO) syndrome are discussed. This syndrome may not have been previously reported.