How skinny is skinny?

Ruth and I have both referred on this blog to children who have suffered/are suffering from malnutrition. The thing that staggers you looking at them is how skinny their limbs are--tiny, stick-like--how do you describe it without ending up in cliche? As I was holding a two-year old orphan at hippotherapy, it occured to me to actually measure his leg.

Start by making a circle by putting the tip of your index finger on the tip of your thumb. Now move the tip of your index finger to the first knuckle of your thumb. That's how big around sixteen-month Eleanor's ankle is. Now move the tip of your index finger to the second knuckle of your thumb (where it attaches to your hand). That's how big this two year old's ankle was.