Diagnostic ultrasound ( PDFDrive )

1406 PART IV Obstetric and Fetal Sonography
A
B
C
D
E
F
G
H
FIG. 40.36 Collage of Hand and Foot Anomalies. (A) Talipes equinovarus (clubfoot). Inverted plantar lexion with medial deviation of the
foot results in visualization of the long axis of the foot (metatarsals) and lower leg in the same plane. Note the rounded angle between the foot
and lower leg. (B) Rocker-bottom foot. Convex sole contour and rounded soft tissue protrusion posterior to the calf soft tissues. (C) Toe polydactyly,
six digits. (D) Oligodactyly, three digits. (E) Syndactyly. Soft tissue fusion of the irst and second digits. (F) Sandal toes in a 37-week fetus with
Nager syndrome demonstrates an exaggerated gap between the irst and second toes and a plantar skin furrow. (G) Clinodactyly. Hypoplastic
middle phalanx of ifth digit. (H) Ectrodactyly, or split hand or foot deformity. (C and E courtesy of Ants Toi, MD, University of Toronto; D and H
courtesy of Shia Salem, MD, University of Toronto.)
such as Fanconi syndrome, Holt-Oram syndrome, acrocephalosyndactyly,
and conditions associated with triphalangeal
thumb. 73 Central polydactyly can also occur.
Syndactyly refers to sot tissue and/or osseous fusion of digits
(Fig. 40.36E). Syndactyly of the third and fourth ingers in
association with IUGR in the second trimester suggests the
diagnosis of triploidy.
An abducted, low-set thumb, or hitchhiker thumb (see Fig.
40.25), is associated with diastrophic dwarism. An adducted
thumb may be associated with aqueductal stenosis.
Ectrodactyly, or the split hand or foot “lobster claw”
deformity, is a deiciency of the central digits resulting in a clet.
It can occur as an isolated abnormality or in association with
other indings, such as clet lip and/or palate, as in