Diagnostic ultrasound ( PDFDrive )

CHAPTER 40 The Fetal Musculoskeletal System 1405
A
B
C
D
FIG. 40.34 Arthrogryposis Multiplex Congenita. Decreased muscle bulk is replaced by a mixture of fat and adipose tissue, resulting in
multiple congenital joint contractures, including ixed internal rotation of shoulders, hyperextension of elbows, lexion of wrists, and talipes equinovarus
(clubfoot). Note that severity of deformity increases distally. The knees and hips at birth were demonstrated to be nonrigid contractures amenable
to conservative postural therapy. (A) Photograph demonstrates ixed contractures of the elbows, wrists, digits, and ankles. (B) Radiograph demonstrates
similar contractures. (C) Ultrasound of upper extremity demonstrates ixed extension of the elbow and ixed lexion of the wrist and digits with
talipomanus. (D) “Buddha position” with lexed hips, knees, and ankles and clubfoot distally.
A
B
FIG. 40.35 Hereditary Lymphedema at 21 Weeks. (A) Femur surrounded by marked thickening of the subcutaneous tissues. (B) Lower
extremity with marked thickening of subcutaneous tissues.
mild degree of clinodactyly. 106 Camptodactyly is the permanent
lexion of a inger caused by lexion contracture of an interphalangeal
joint.
Polydactyly is the presence of extra digits on the foot or hand.
Most cases are isolated, but extra digits can be associated with
syndromes and chromosomal abnormalities. Polydactyly may
be diagnosed toward the end of the irst trimester. he extra
digit may consist of a small, sot tissue projection or a complete
digit. Postaxial polydactyly (ulnar or ibular) is more common
and is found in conditions such as Ellis–van Creveld syndrome,
asphyxiating thoracic dystrophy, short-rib polydactyly syndrome,
and trisomy 13.
Polydactyly may be an isolated inding and can be hereditary
and familial. Because this form is associated with a good prognosis,
it is important to review the pertinent family history. Preaxial
(radial or tibial) polydactyly is found in familial conditions,