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Li MW, Li F, Cheng ZX, Cheng J, Wu Q, Wang ZX, Wang F, Zhou P. Biallelic truncating TTN variants in M-band encoding exons cause a fetal lethal titinopathy. Prenat Diagn 2024; 44:81-87. [PMID: 38148006 DOI: 10.1002/pd.6491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023]
Abstract
To report two novel TTN variants associated with fetal recessive titinopathy, thereby broadening the range of TTN variants that can lead to titinopathy. Clinical information on the fetus and parents was gathered, and genomic DNAs were extracted from the fetal tissue and family members' peripheral blood samples. Exome sequencing on fetal DNA was performed and following bioinformatics analysis, the suspected pathogenic variants were confirmed through Sanger sequencing. Prenatal ultrasound performed at 29 weeks of gestation revealed hydrops fetalis, decreased fetal movements, multiple joint contractures and polyhydramnios. Intrauterine fetal death was noted in the third trimester. Exome sequencing revealed compound heterozygous variants in the TTN gene: a paternally inherited allele c.101227C>T (p.Arg33743Ter) and a maternally inherited c.104254C>T (p.Gln34752Ter) allele. These variants have not been previously reported and are evaluated to be likely pathogenic according to the American College of Medical Genetics and Genomics guidelines. We report a fetus with hydrops fetalis and arthrogryposis multiplex congenita associated with a compound heterozygote in the TTN gene. Our report broadens the clinical and genetic spectrum associated with the TTN-related conditions.
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Affiliation(s)
- Ming-Wei Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, Anhui, China
| | - Fan Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, Anhui, China
| | - Zhen-Xing Cheng
- Frontier Research Center, School of Medicine, Anhui University of Science and Technology, Huainan, Anhui, China
| | - Jin Cheng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, Anhui, China
| | - Quan Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, Anhui, China
| | - Zhi-Xin Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, Anhui, China
| | - Fei Wang
- Frontier Research Center, School of Medicine, Anhui University of Science and Technology, Huainan, Anhui, China
| | - Ping Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, Anhui, China
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2
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Shafqat G, Fatima K, Hanif F. Foetal Akinesia Deformation Sequence: A Rare Lethal Entity. J PAK MED ASSOC 2023; 73:2266-2268. [PMID: 38013544 DOI: 10.47391/jpma.8513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Foetal akinesia deformation sequence (FADS) represents a group of disorders resulting from absent or diminished in utero foetal mobility. The aetiology is multifactorial, including genetic, environmental, maternal, and foetal causes. The absence of foetal movements leading to multiple joint contractures, pulmonary hypoplasia, and intrauterine growth restriction are the key features of foetal akinesia deformation sequence. Herein we describe the case of a 30-year-old gravida 4 (para 2+1) who came for foetal ultrasound at 28 weeks of gestation due to decreased foetal movements. Ultrasound showed features of FADS with fixed flexed position of foetal limbs, pulmonary hypoplasia, polyhydramnios, and intrauterine growth restriction. The timely use of ultrasound enables early detection of these cases and aids in appropriate counselling and management.
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Affiliation(s)
- Gulnaz Shafqat
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Kulsoom Fatima
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Farida Hanif
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
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3
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Cummings JL, Hosseinzadeh P. Congenital vertical talus deformity in children with distal arthrogryposis: good clinical outcomes despite high rate of residual radiographic deformity. J Pediatr Orthop B 2023; 32:428-434. [PMID: 36595217 DOI: 10.1097/bpb.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Patients with a diagnosis of arthrogryposis often present with various orthopedic conditions, one of which is congenital vertical talus (CVT). This is the first study of this specific subset of syndromic patients to evaluate the medium-term outcomes of CVT correction using the minimally invasive Dobbs method. All patients with vertical talus and distal arthrogryposis who received treatment at our institution between January 2006 and June 2021 were identified. Radiographs, clinical notes and Patient-Reported Outcome Measurement Information System (PROMIS) scores (when available) were retrospectively reviewed. An alpha of 0.05 was used for all statistical analyses. In total 12 patients (19 feet) met all inclusion criteria and were included in the final analysis. By the time of the most recent visit, the average lateral Talar-Axis First Metatarsal Base Angle of the entire cohort increased from 13.73 ± 9.75 degrees 2 weeks postoperatively to 28.75 ± 23.73 degrees ( P = 0.0076). Radiographic recurrence of the talonavicular deformity was seen in nine feet (47.4%), 4 (21.1%) of which required additional unplanned surgery, The average PROMIS scores of the entire cohort in the pain interference, mobility and peer relationship domains were 48.97 ± 9.56, 47.9 ± 11.60 and 52.87 ± 8.31, respectively. Despite a higher radiographic recurrence rate of talonavicular deformity in this specific subset of syndromic patients, these patients still report PROMIS scores near the population average in the pain interference, mobility and peer relationships domains. We believe that the minimally invasive Dobbs method should be recommended as the first-line treatment method for these patients. Level of evidence: Level III.
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Affiliation(s)
- Jason L Cummings
- Department of Orthopaedic Surgery, Washington University in St. Louis, Saint Louis, Missouri, USA
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4
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Filges I, Jünemann S, Viehweger E, Tercanli S. Fetal arthrogryposis-what do we tell the prospective parents? Prenat Diagn 2023; 43:798-805. [PMID: 36588183 DOI: 10.1002/pd.6299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/11/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023]
Abstract
Arthrogryposis, also termed arthrogryposis multiplex congenita, is a descriptive term for conditions with multiple congenital contractures (MCC). The etiology is extremely heterogeneous. More than 400 specific disorders have been identified so far, which may lead to or are associated with MCC and/or fetal hypo- and akinesia as a clinical sign. With improved sensitivity of prenatal ultrasound and expanding prenatal diagnostic options, clinicians are tasked with providing early detection in order to counsel the prospective parents regarding further prenatal diagnostic as well as management options. We summarize the most important knowledge to raise awareness for early detection in pregnancy. We review essential points for counseling when MCC is detected in order to provide answers to common questions, which, however, cannot replace interdisciplinary expert opinion in the individual case.
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Affiliation(s)
- Isabel Filges
- Medical Genetics, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Stephanie Jünemann
- Pediatric Neurology and Developmental Medicine, University Children's Hospital Basel UKBB and University of Basel, Basel, Switzerland
| | - Elke Viehweger
- Pediatric Orthopedics, Neuro-Orthopedics and Movement Analysis Center, University Children's Hospital Basel UKBB and University of Basel, Basel, Switzerland
| | - Sevgi Tercanli
- Center for Prenatal Ultrasound, Basel and University of Basel, Basel, Switzerland
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5
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Tjon JK, Tan-Sindhunata MB, Bugiani M, Witbreuk MMEH, van der Sluijs JA, Weiss MM, van Weissenbruch MM, van de Pol LA, Buizer AI, van Doesburg MHM, Bakker PCAM, van der Knoop BJ, Linskens IH, de Vries JIP. Care pathway for fetal joint contractures, Fetal Akinesia Deformation Sequence and Arthrogryposis Multiplex Congenita. Fetal Diagn Ther 2021; 48:829-839. [PMID: 34775380 DOI: 10.1159/000520869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/26/2021] [Indexed: 11/19/2022]
Abstract
Introduction The majority of arthrogryposis multiplex congenita (AMC) and lethal forms of AMC such as fetal akinesia deformation sequence (FADS) cases are missed prenatally. We have demonstrated the additional value of fetal motor assessment and evaluation in a multidisciplinary team for the period 2007-2016. An applied care pathway for fetuses presenting with joint contracture(s) in one anatomic region (e.g. talipes equinovares), more than one body part with non-progressive contractures and motility (AMC) and with deterioration over time (FADS). Methods The multidisciplinary team of Amsterdam University Medical Centre Expertise Centre FADS and AMC developed the care pathway. Additional tools are provided including a motor assessment by ultrasound examination and postmortem assessment form. Results An eight-step care pathway is presented with a proposed timing for prenatal sonographic examination, genetic examinations, multidisciplinary meetings, prenatal and postnatal counselling of the parents by specialist also treating after birth, follow-up of prenatal and postnatal findings with counselling for future pregnancies. Discussion/conclusion The scheduled serial structural and motor sonograpahic assessment together with follow-up examinations and genetic analysis, should be tailored per prenatal centre per available resources. The multidisciplinary care pathway may pave the way to increase detection rate and diagnosis of isolated contracture(s), talipes equinovares with underlying genetic causes and the rare phenotypes AMC/FADS and prompt treatment after birth within expertise teams.
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Affiliation(s)
- Jill K Tjon
- Department of Obstetrics and Gynaecology, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria B Tan-Sindhunata
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marianna Bugiani
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Melinda M E H Witbreuk
- Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes A van der Sluijs
- Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjan M Weiss
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mirjam M van Weissenbruch
- Department of Child Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura A van de Pol
- Department of Paediatrics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine and Emma Children's Hospital, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Petra C A M Bakker
- Department of Obstetrics and Gynaecology, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bloeme J van der Knoop
- Department of Obstetrics and Gynaecology, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg H Linskens
- Department of Obstetrics and Gynaecology, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johanna I P de Vries
- Department of Obstetrics and Gynaecology, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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6
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Dahan-Oliel N, Collins J, Rauch D, Bukovy G, Hamdy R, Rauch F. Bone densities and bone geometry in children and adolescents with arthrogryposis. Bone 2020; 137:115454. [PMID: 32464275 DOI: 10.1016/j.bone.2020.115454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/07/2020] [Accepted: 05/23/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To describe bone densitometry results using lumbar spine dual-energy X-ray absorptiometry and forearm peripheral quantitative computed tomography (pQCT) in children with arthrogryposis multiplex congenita (AMC). STUDY DESIGN Prospective study. RESULTS Lumbar spine areal bone mineral density (BMD) was measured in 58 participants (mean age 6.8 years, range 1 month to 19.7 years; 26 males). The diagnostic subgroup was Amyoplasia in 27 participants, distal arthrogryposis (unclassified, n = 13; type 2A, n = 1; type 2B, n = 2; type 8, n = 2) in 18 patients, an unclassified form of arthrogryposis in 6 patients, and a syndromic form of arthrogryposis in 7 patients. The mean lumbar spine areal BMD was -0.4 (SD: 1.5) which was significantly below 0 (p < 0.05, one-sample t-test). The mean lumbar spine bone mineral apparent density z-score (+0.4 [SD: 1.4]), a measure that is largely independent of bone size, was not significantly different from 0 (P > 0.05). A subset of 22 patients aged 6 years or older (mean age 10.9 years, 11 males) had forearm pQCT analysis. Mean z-scores for trabecular and cortical volumetric BMD at the radius were similar to healthy controls. Radius periosteal bone circumference and bone mineral content were appropriate for height. These densitometric results did not differ between patients with Amyoplasia or individuals with other diagnoses. CONCLUSIONS Low areal BMD in children and adolescents with AMC reflects their smaller bone size rather than a specific bone mass deficit. These data do not suggest that children and adolescents with AMC in general require regular monitoring by bone densitometry unless there are specific clinical concerns.
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Affiliation(s)
- Noemi Dahan-Oliel
- Shriners Hospital for Children, Montreal, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Damian Rauch
- Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Gloria Bukovy
- Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Reggie Hamdy
- Shriners Hospital for Children, Montreal, Quebec, Canada; Faculty of Medicine, Division of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada
| | - Frank Rauch
- Shriners Hospital for Children, Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
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7
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Seidahmed MZ, Al-Kindi A, Alsaif HS, Miqdad A, Alabbad N, Alfifi A, Abdelbasit OB, Alhussein K, Alsamadi A, Ibrahim N, Al-Futaisi A, Al-Maawali A, Alkuraya FS. Recessive mutations in SCYL2 cause a novel syndromic form of arthrogryposis in humans. Hum Genet 2020; 139:513-519. [PMID: 31960134 DOI: 10.1007/s00439-020-02117-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/10/2020] [Indexed: 12/20/2022]
Abstract
Arthrogryposis multiplex congenita (AMC) is an important birth defect with a significant genetic contribution. Many syndromic forms of AMC have been described, but remain unsolved at the molecular level. In this report, we describe a novel syndromic form of AMC in two multiplex consanguineous families from Saudi Arabia and Oman. The phenotype is highly consistent, and comprises neurogenic arthrogryposis, microcephaly, brain malformation (absent corpus callosum), optic atrophy, limb fractures, profound global developmental delay, and early lethality. Whole-exome sequencing revealed a different homozygous truncating variant in SCYL2 in each of the two families. SCYL2 is a component of clathrin-coated vesicles, and deficiency of its mouse ortholog results in a severe neurological phenotype that largely recapitulates the phenotype observed in our patients. Our results suggest that severe neurogenic arthrogryposis with brain malformation is the human phenotypic consequence of SCYL2 loss of function mutations.
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Affiliation(s)
| | - Adila Al-Kindi
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hessa S Alsaif
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abeer Miqdad
- Deparment of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Nasser Alabbad
- Department of Obstetrics and Gynaecology, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdallah Alfifi
- Deparment of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | | | - Khalid Alhussein
- Deparment of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | | | - Niema Ibrahim
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amna Al-Futaisi
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Almundher Al-Maawali
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
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8
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Abstract
A 17-year-old man with no familial history developed motor and sensory disturbance of the left upper limb a few days after starting push-up exercise. Neurological examination revealed broad weakness and radial sensory disturbance of the left upper limb and magnetic resonance neurography showed laterality of brachial plexus intensity signals. Therefore, we suspected left brachial plexopathy. However, a nerve conduction study showed a broad disturbance that could not be explained by only brachial plexopathy. Genetic tests revealed a diagnosis of hereditary neuropathy with liability to pressure palsies (HNPP). HNPP should be included in the differential diagnosis for neuropathy due to slight exercise or nerve compression even when familial history is negative.
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Affiliation(s)
- Takumi Nakamura
- Department of Neurology, Hirosaki University Graduate School of Medicine
| | | | - Yusuke Seino
- Department of Neurology, Hirosaki University Graduate School of Medicine
| | - Mikio Shoji
- Department of Neurology, Hirosaki University Graduate School of Medicine
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9
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Gistelinck C, Witten PE, Huysseune A, Symoens S, Malfait F, Larionova D, Simoens P, Dierick M, Van Hoorebeke L, De Paepe A, Kwon RY, Weis M, Eyre DR, Willaert A, Coucke PJ. Loss of Type I Collagen Telopeptide Lysyl Hydroxylation Causes Musculoskeletal Abnormalities in a Zebrafish Model of Bruck Syndrome. J Bone Miner Res 2016; 31:1930-1942. [PMID: 27541483 PMCID: PMC5364950 DOI: 10.1002/jbmr.2977] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 08/09/2016] [Accepted: 08/17/2016] [Indexed: 11/11/2022]
Abstract
Bruck syndrome (BS) is a disorder characterized by joint flexion contractures and skeletal dysplasia that shows strong clinical overlap with the brittle bone disease osteogenesis imperfecta (OI). BS is caused by biallelic mutations in either the FKBP10 or the PLOD2 gene. PLOD2 encodes the lysyl hydroxylase 2 (LH2) enzyme, which is responsible for the hydroxylation of lysine residues in fibrillar collagen telopeptides. This hydroxylation directs crosslinking of collagen fibrils in the extracellular matrix, which is necessary to provide stability and tensile integrity to the collagen fibrils. To further elucidate the function of LH2 in vertebrate skeletal development, we created a zebrafish model harboring a homozygous plod2 nonsense mutation resulting in reduced telopeptide hydroxylation and crosslinking of bone type I collagen. Adult plod2 mutants present with a shortened body axis and severe skeletal abnormalities with evidence of bone fragility and fractures. The vertebral column of plod2 mutants is short and scoliotic with compressed vertebrae that show excessive bone formation at the vertebral end plates, and increased tissue mineral density in the vertebral centra. The muscle fibers of mutant zebrafish have a reduced diameter near the horizontal myoseptum. The endomysium, a layer of connective tissue ensheathing the individual muscle fibers, is enlarged. Transmission electron microscopy of mutant vertebral bone shows type I collagen fibrils that are less organized with loss of the typical plywood-like structure. In conclusion, plod2 mutant zebrafish show molecular and tissue abnormalities in the musculoskeletal system that are concordant with clinical findings in BS patients. Therefore, the plod2 zebrafish mutant is a promising model for the elucidation of the underlying pathogenetic mechanisms leading to BS and the development of novel therapeutic avenues in this syndrome. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
| | | | - Ann Huysseune
- Biology Department, Ghent University, Ghent, Belgium
| | - Sofie Symoens
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
| | | | | | - Pascal Simoens
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
| | - Manuel Dierick
- UGCT, Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Luc Van Hoorebeke
- UGCT, Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Anne De Paepe
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
| | - Ronald Y Kwon
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - MaryAnn Weis
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - David R Eyre
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Andy Willaert
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
| | - Paul J Coucke
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
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10
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Ravenscroft G, Di Donato N, Hahn G, Davis MR, Craven PD, Poke G, Neas KR, Neuhann TM, Dobyns WB, Laing NG. Recurrent de novo BICD2 mutation associated with arthrogryposis multiplex congenita and bilateral perisylvian polymicrogyria. Neuromuscul Disord 2016; 26:744-748. [PMID: 27751653 DOI: 10.1016/j.nmd.2016.09.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 09/05/2016] [Accepted: 09/13/2016] [Indexed: 01/10/2023]
Abstract
Autosomal dominantly inherited mutations of BICD2 are associated with congenital-onset spinal muscular atrophy characterised by lower limb predominance. A few cases have also showed upper motor neuron pathology, including presenting with features resembling hereditary spastic paraplegia. The age-of-onset for the published families is usually at birth but also included cases with childhood- and adult-onset disease. In this report we described two isolated probands that presented in utero with features associated with reduced fetal movements. Both cases were diagnosed at birth with arthrogryposis multiplex congenita (AMC) and hypotonia. Other variable features included congenital fractures, hip dislocation, micrognathia, respiratory insufficiency, microcephaly and bilateral perisylvian polymicrogyria. Patient 1 is 4 years of age and stable, but shows significant motor developmental delay and delayed speech. Patient 2 passed away at 7 weeks of age. Through next generation sequencing we identified the same missense substitution in BICD2 (p.Arg694Cys) in both probands. Sanger sequencing showed that in both cases the mutation arose de novo. The in utero onset in both cases suggests that the p.Arg694Cys substitution may have a more deleterious effect on BICD2 function than previously described mutations. Our results broaden the phenotypes associated with BICD2 mutations to include AMC and cortical malformations and therefore to a similar phenotypic spectrum to that associated with its binding partner DYNC1H1.
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Affiliation(s)
- Gianina Ravenscroft
- Centre for Medical Research, The University of Western Australia and Harry Perkins Institute for Medical Research, Nedlands, Western Australia, Australia.
| | - Nataliya Di Donato
- Institut für Klinische Genetik, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Gabriele Hahn
- Institut und Poliklinik für Radiologische Diagnostik, Universitätsklinikum Dresden, Dresden, Germany
| | - Mark R Davis
- Department of Diagnostic Genomics, Pathwest, Nedlands, Western Australia, Australia
| | - Paul D Craven
- John Hunter Children's Hospital, Hunter Valley, New South Wales, Australia
| | - Gemma Poke
- Genetic Health Services, Auckland, New Zealand
| | | | | | | | - Nigel G Laing
- Centre for Medical Research, The University of Western Australia and Harry Perkins Institute for Medical Research, Nedlands, Western Australia, Australia; Department of Diagnostic Genomics, Pathwest, Nedlands, Western Australia, Australia
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11
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van der Linden V, Filho ELR, Lins OG, van der Linden A, Aragão MDFVV, Brainer-Lima AM, Cruz DDCS, Rocha MAW, Sobral da Silva PF, Carvalho MDCG, do Amaral FJ, Gomes JA, Ribeiro de Medeiros IC, Ventura CV, Ramos RC. Congenital Zika syndrome with arthrogryposis: retrospective case series study. BMJ 2016; 354:i3899. [PMID: 27509902 PMCID: PMC4979356 DOI: 10.1136/bmj.i3899] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. DESIGN Retrospective case series study. SETTING Association for Assistance of Disabled Children, Pernambuco state, Brazil. PARTICIPANTS Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. MAIN OUTCOME MEASURES Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. RESULTS The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. CONCLUSIONS Congenital Zika syndrome should be added to the differential diagnosis of congenital infections and arthrogryposis. The arthrogryposis was unrelated to the abnormalities of the joints themselves, but was possibly of neurogenic origin, with chronic involvement of central and peripheral motor neurones leading to deformities as a result of fixed postures in utero. Based on the neurophysiological observations, we suggest two possible mechanisms: tropism of neurones, with involvement of peripheral and central motor neurones, or a relation with vascular disorders.
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Affiliation(s)
- Vanessa van der Linden
- Association for Assistance of Disabled Children, AACD, Recife, Brazil Barão de Lucena Hospital, HBL, Recife, Brazil
| | - Epitacio Leite Rolim Filho
- Association for Assistance of Disabled Children, AACD, Recife, Brazil Federal University of Pernambuco, UFPE, Recife, Brazil
| | | | - Ana van der Linden
- Prof Fernando Figueira Integral Medicine Institute, IMIP, Recife, Brazil
| | | | | | | | | | | | | | | | | | | | - Camila V Ventura
- Altino Ventura Foundation, FAV, Recife, Brazil Pernambuco's Eye Hospital, Recife, Brazil
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Malfatti E, Barnerias C, Hedberg-Oldfors C, Gitiaux C, Benezit A, Oldfors A, Carlier RY, Quijano-Roy S, Romero NB. A novel neuromuscular form of glycogen storage disease type IV with arthrogryposis, spinal stiffness and rare polyglucosan bodies in muscle. Neuromuscul Disord 2016; 26:681-687. [PMID: 27546458 DOI: 10.1016/j.nmd.2016.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 07/06/2016] [Accepted: 07/11/2016] [Indexed: 01/11/2023]
Abstract
Glycogen storage disease type IV (GSD IV) is an autosomal recessive disorder causing polyglucosan storage in various tissues. Neuromuscular forms present with fetal akinesia deformation sequence, lethal myopathy, or mild hypotonia and weakness. A 3-year-old boy presented with arthrogryposis, motor developmental delay, weakness, and rigid spine. Whole body MRI revealed fibroadipose muscle replacement but sparing of the sartorius, gracilis, adductor longus and vastus intermedialis muscles. Polyglucosan bodies were identified in muscle, and GBE1 gene analysis revealed two pathogenic variants. We describe a novel neuromuscular GSD IV phenotype and confirm the importance of muscle morphological studies in early onset neuromuscular disorders.
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Affiliation(s)
- Edoardo Malfatti
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS974, CNRS FRE3617, Center for Research in Myology, GHU La Pitié-Salpêtrière, 47 Boulevard de l'hôpital, 75013 Paris, France; Unité de Morphologie Neuromusculaire, Institut de Myologie, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France; Centre de référence de Pathologie Neuromusculaire Paris-Est, Institut de Myologie, GHU La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France
| | - Christine Barnerias
- Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France; AP-HP, Service de Neuropédiatrie, Hôpital Necker-Enfants Malades, Paris, France; Centre de Référence Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Paris, France
| | - Carola Hedberg-Oldfors
- Department of Pathology and Genetics, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Cyril Gitiaux
- Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France; Centre de Référence Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Paris, France; AP-HP Service des Explorations Foctionnelles Neurologiques, Höpital Universitaire Necker-Enfants Malades, Paris, France
| | - Audrey Benezit
- Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France; AP-HP, Service de Neuropédiatrie, Hôpital Necker-Enfants Malades, Paris, France; Centre de Référence Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Paris, France
| | - Anders Oldfors
- Department of Pathology and Genetics, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Robert-Yves Carlier
- Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France; Centre de Référence Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Paris, France; U1179 INSERM-UVSQ, Université Versailles Saint-Quentin en Yvelines, Montigny, France; AP-HP, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Paris, France
| | - Susana Quijano-Roy
- Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France; Centre de Référence Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Paris, France; AP-HP, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Paris, France
| | - Norma B Romero
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS974, CNRS FRE3617, Center for Research in Myology, GHU La Pitié-Salpêtrière, 47 Boulevard de l'hôpital, 75013 Paris, France; Unité de Morphologie Neuromusculaire, Institut de Myologie, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France; Centre de référence de Pathologie Neuromusculaire Paris-Est, Institut de Myologie, GHU La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Filière Nationale de Maladies Neuromusculaires (FILNEMUS), Marseille, France.
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Abstract
A study was performed to investigate the morphological expression of the inherited syndrome “complex vertebral malformation” (CVM) in Holstein calves. A total of 107 late-term aborted, premature, or neonatal calves suspected of having CVM were necropsied and retrospectively analyzed for the causal mutation in the gene SLC35A3. Sixty-two calves were homozygous affected, 16 were heterozygous, and 29 were homozygous normal. Calves affected by CVM were growth retarded. Vertebral lesions identified by radiography were present in 61 cases, of which 58 also had costal malformation. Malformation of the head, primarily in the form of dysplasia or palatoschisis, was present in 15 cases. Bilateral symmetric flexion of the carpal and metacarpophalangeal joints was present in all cases, whereas posterior arthrogryposis was found in 54 cases. Interventricular septal defects occurred in 33 calves, often in combination with other cardiac malformations. A wide spectrum of additional malformations was found. Other congenital syndromes were in most cases distinguishable from CVM on a morphological basis. However, a calf with a prenatal infection with bovine virus diarrhea virus constituted a phenocopy. The study demonstrated that the morphological expression of CVM is wide, but certain aspects, i.e., growth retardation, vertebral malformation, and symmetric arthrogryposis, are almost constant findings. However, cases without vertebral defects and phenocopies constitute a diagnostic problem. A presumptive diagnosis of CVM can in most cases be based on necropsy findings combined with information on descent and paternal CVM genotype, whereas a definitive diagnosis requires genotyping.
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Affiliation(s)
- Jorgen S Agerholm
- Department of Veterinary Pathobiology and Clinical Studies, Royal Veterinary and Agricultural University, Bulowsvej 17, DK-1870 Frederiksberg C, Denmark
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Karaman A, Aydin H, Göksu K. Concomitant omphalocele, anencephaly and arthrogryposis associated with trisomy 18. Genet Couns 2015; 26:77-79. [PMID: 26043511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
MESH Headings
- Abnormalities, Multiple/diagnostic imaging
- Abnormalities, Multiple/genetics
- Abortion, Induced
- Adult
- Anencephaly/diagnostic imaging
- Anencephaly/genetics
- Arthrogryposis/diagnostic imaging
- Arthrogryposis/genetics
- Chromosomes, Human, Pair 18/diagnostic imaging
- Chromosomes, Human, Pair 18/genetics
- Female
- Hernia, Umbilical/diagnostic imaging
- Hernia, Umbilical/genetics
- Humans
- Pregnancy
- Trisomy/genetics
- Trisomy 18 Syndrome
- Ultrasonography, Prenatal
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15
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Padua L, Briani C. The different ultrasound patterns in Charcot-Marie-Tooths raise the need of standardization. Clin Neurophysiol 2014; 126:1286-7. [PMID: 25454275 DOI: 10.1016/j.clinph.2014.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 10/01/2014] [Accepted: 10/03/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Luca Padua
- Neurology Unit, Catholic University of the Sacred Heart, Rome, Italy; Don Carlo Gnocchi Foundation, Piazzale Morandi n. 6, 20100 Milan, Italy.
| | - Chiara Briani
- Department of Neurosciences, Sciences NPSRR, University of Padova, Italy
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Inbar-Feigenberg M, Meirowitz N, Nanda D, Toi A, Okun N, Chitayat D. Beals syndrome (congenital contractural arachnodactyly): prenatal ultrasound findings and molecular analysis. Ultrasound Obstet Gynecol 2014; 44:486-490. [PMID: 24585410 DOI: 10.1002/uog.13350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/24/2014] [Accepted: 02/11/2014] [Indexed: 06/03/2023]
Abstract
We report the prenatal findings in two cases of Beals syndrome. Both pregnancies presented with clinical features of arthrogryposis multiplex congenita/fetal akinesia syndrome (AMC/FAS), including clenched fists and multiple joint contractures on repeat prenatal ultrasound examinations. The first case was diagnosed as having Beals syndrome on physical examination shortly after birth and the diagnosis was confirmed by DNA analysis, shown as a point mutation in the fibrillin 2 (FBN2) gene. The second case was diagnosed with Beals syndrome following microarray analysis on amniocytes, which showed a deletion of the FBN2 gene. Although most cases with AMC/FAS carry a poor prognosis, Beals syndrome is consistent with normal cognitive development and a better prognosis. Thus, making the correct diagnosis is crucial, both pre- and postnatally, for accurate counseling and management.
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Affiliation(s)
- M Inbar-Feigenberg
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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17
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Abstract
OBJECTIVES The aims of this study were to evaluate the sonographic findings of patients with hereditary neuropathy with liability to pressure palsies (HNPP) and to examine the correlation between sonographic and electrophysiological findings. METHODS Nine patients whose electrophysiological findings indicated HNPP and whose diagnosis was confirmed by genetic analysis were enrolled in the study. The median, ulnar, peroneal, and tibial nerves were evaluated by ultrasonography. RESULTS We ultrasonographically evaluated 18 median, ulnar, peroneal, and tibial nerves. Nerve enlargement was identified in the median, ulnar, and peroneal nerves at the typical sites of compression. None of the patients had nerve enlargement at a site of noncompression. None of the tibial nerves had increased cross-sectional area (CSA) values. There were no significant differences in median, ulnar, and peroneal nerve distal motor latencies (DMLs) between the patients with an increased CSA and those with a normal CSA. In most cases, there was no correlation between electrophysiological abnormalities and clinical or sonographic findings. DISCUSSION Although multiple nerve enlargements at typical entrapment sites on sonographic evaluation can suggest HNPP, ultrasonography cannot be used as a diagnostic tool for HNPP. Ultrasonography may contribute to the differential diagnosis of HNPP and other demyelinating polyneuropathies or compression neuropathies; however, further studies are required.
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18
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Fisher KA, Fisher DA. Total hip and knee replacement in a patient with arthrogryposis multiplex congenita. Am J Orthop (Belle Mead NJ) 2014; 43:E79-E82. [PMID: 24730009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Arthrogryposis multiplex congenita (AMC) is a complex disorder that leads to joint stiffness and deformities in 2 or more joints in afflicted children. Late manifestations of this disorder can include secondary degeneration of the abnormal joints with arthritic symptoms of pain and loss of function. There are few reports in the orthopedic literature on the use of total joint arthroplasty to improve the pain and function in patients with arthrogryposis. This case report presents one patient who underwent bilateral total hip and total knee arthroplasties for deteriorating function and pain in her hips and knees secondary to the congenital deformities created by arthrogryposis multiplex congenita. We discuss the intraoperative difficulties and techniques used to reconstruct her hips and knees, as well as the potential indications for joint arthroplasty in this challenging group of patients.
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Affiliation(s)
| | - David A Fisher
- Indiana University School of Medicine; Total Joint Center, Indiana Orthopaedic Hospital, Indianapolis, IN.
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19
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Kdous M, Takali Z, Ferchiou M, Zhioua F. The pena-shoker syndrome type I: clinicopathological report of a recurrent case. Tunis Med 2014; 92:167. [PMID: 24938241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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20
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Thabet AM, Kowtharapu DN, Miller F, Dabney KW, Shah SA, Rogers K, Holmes L. Wrist fusion in patients with severe quadriplegic cerebral palsy. Musculoskelet Surg 2012; 96:199-204. [PMID: 22893448 DOI: 10.1007/s12306-012-0217-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 07/25/2012] [Indexed: 06/01/2023]
Abstract
We report clinical and radiographic outcomes of wrist fusion achieved with pin or plate fixation in 14 patients with severe quadriplegic cerebral palsy (CP) (19 wrists). Average patient age at the time of surgery was 16.8 ± 1.7 years (14-20 years). Mean follow-up time for the 14 patients was 5.9 ± 3.1 years (range, 1-11 years). Indication for surgery was severe wrist deformity that interfered with hygienic care. Few complications occurred, and outcomes were satisfactory. Statistically significant mean difference was shown between the pre- and postoperative radiographic angles (37°, P = 0.001, and 24°, P = 0.04, for lateral and anteroposterior views, respectively). Caregivers reported that appearance was the most perceived rationale for surgery (63 %). Improved hygienic care was the primary perceived benefit. The majority (88 %) were satisfied with the results. We recommend wrist fusion to improve hygienic care, positioning, and appearance of the wrist, hand, and fingers in patients with severe quadriplegic CP.
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Affiliation(s)
- Ahmed M Thabet
- Department of Orthopedics, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, 1600 Rockland Road, Wilmington, DE 19803, USA.
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21
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Haynes JM, Mitchell H. Ultrasound-guided arterial puncture. Respir Care 2010; 55:1754-1756. [PMID: 21122184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Jeffrey M Haynes
- Department of Respiratory Therapy, St Joseph Hospital, 172 Kinsley Street, Nashua, NH 03060, USA.
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22
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Dane B, Dane C, Aksoy F, Cetin A, Yayla M. Arthrogryposis multiplex congenita: analysis of twelve cases. CLIN EXP OBSTET GYN 2009; 36:259-262. [PMID: 20101863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The term arthrogryposis multiplex congenita (AMC) refers to multiple joint contractures present at birth. AMC is not a specific disorder but is the consequence of neurological, muscular, connective tissue, and skeletal abnormalities or intrauterine crowding, which may lead to limitation of fetal joint mobility and the development of contractures. METHODS Cases referred to our perinatology department for detailed examination were retrospectively analyzed. RESULTS Twelve cases with AMC were detected during the antenatal period. The ultrasound features related to the "lack of movement" included limb abnormalities (multiple contractures, clenched hands, and clubbed feet), short umbilical cord, polyhydramnios, pulmonary hypoplasia, camptodactyly, and micrognathia. Five of the early detected cases (71%) were found to have increased nuchal translucency or nuchal fold. All of the cases at the third trimester resulted in neonatal death. CONCLUSION First trimester screening may be useful for early diagnosis of AMC. Sonographic findings in late pregnancy might be helpful in predicting the prognosis. Due to the high recurrence risk, a specific screening program should be performed for the following pregnancies by examination of the fetus several times for movement and position of the limbs.
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Affiliation(s)
- B Dane
- Department of Gynecology & Obstetrics Clinic, Division of Perinatology, Haseki Training & Research Hospital, Istanbul University, Istanbul, Turkey
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23
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Feldman-Leidner N, Delaney K, Malikina M, Segarra P, Tiller GR, Singer T, Divon MY. Restrictive dermopathy: two- and three-dimensional sonographic features. Ultrasound Obstet Gynecol 2008; 32:840-842. [PMID: 18844329 DOI: 10.1002/uog.6151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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24
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Chelli D, Dimassi K, Bouaziz M, Masmoudi A, Ben Jemaa N, Zouaoui B, Sfar E, Chelli H, Channoufi MB, Gaigi S. [Prenatal ultrasound aspects of arthrogryposis multiplex congenita]. Tunis Med 2008; 86:328-334. [PMID: 19476133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM To analyze the contribution of prenatal ultrasound in the diagnosis of arthrogryposis multiplex congenital according to its type and antenatal expression. METHODS Retrospective study led between January 1993 and November 2007. We studied the cases of arthrogryposis suspected or diagnosed by antenatal ultrasound while analyzing the circumstances of discovery, the profile of the pregnant women and the abnormal scan findings. RESULTS 16 observations have been collected. We recovered one multiple pterigium syndrome and five observations of severe fetal akinesia sequences diagnosed in the second trimester. The arthrogryposis was part of different syndromes in other cases. Four distal arthrogryposis had been diagnosed in the second trimester. All cases suspected during the third trimester were associated to an anomaly of the amniotic fluid, mainly to a polyhydramnios. The abnormal scan findings were less specific to this term. CONCLUSION Arthrogryposis multiplex congenital is rare. It has several morphological aspects. Some ultrasound aspects are specific in the first and second trimesters. The diagnosis is more difficult at the third trimester.
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Affiliation(s)
- Dalenda Chelli
- Service A, Centre de Maternité et de Néonatalogie, Tunis
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25
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Sheizaf B, Mazor M, Landau D, Burstein E, Bashiri A, Hershkovitz R. Early sonographic prenatal diagnosis of seizures. Ultrasound Obstet Gynecol 2007; 30:1007-1009. [PMID: 17948231 DOI: 10.1002/uog.5153] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Fetal seizures are an unusual phenomenon. When diagnosed by ultrasonography, they are frequently associated with malformations and carry a poor prognosis. We describe first trimester seizures in two siblings with arthrogryposis multiplex congenita. In both cases, convulsions appeared before other sonographic signs of the disease. Review of the literature revealed 11 other cases of fetal seizures diagnosed by ultrasound, all later in gestation. Fetal seizures may be the first manifestation of defective neural and motor development. Therefore, in pregnancies at high risk for neuromuscular disease, early sonographic evaluation of fetal motility, in addition to the anatomical survey, is advised.
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Affiliation(s)
- B Sheizaf
- Ultrasound Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
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26
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Altenbrunner-Martinek B, Klein D, Kofler J, Baumgartner W. [Congenital malformation of the front limbs in a llama (Lama glama): polydactyly in combination with arthrogryposis]. Berl Munch Tierarztl Wochenschr 2007; 120:508-512. [PMID: 18085162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A male, 10 month old llama with malformation of both front limbs was presented. Both front limbs had one more digit located medially. The distal phalanx of this additional digit at the left front limb reached the ground by the tip of the keratinzed pad and the toenail. The accessory digit at the right front limb was bent in a 90 degree angle caudolateraly. Beside the digital bones of the accessory digits the second metacarpal bone and the first carpal bone could be detected in both front limbs by radiological examination. Secondary a bilateral slight carpal valgus deformity could be seen.
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Affiliation(s)
- Birgit Altenbrunner-Martinek
- Klinik für Wiederkäuer, Department für Nutztiere und Bestandsbetreuung, Veterinärmedizinische Universität Wien, Osterreich.
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Abstract
PURPOSE OF THE STUDY The navicular bone lies at the apex of the deformity in severe talipes planovalgus with forefoot abductus, in the residual cavus of congenital talipes equinovarus, in certain cases of congenital convexity, and in certain types of neurological equinovarus. Resection of the navicular bone can be proposed to correct certain deformities. MATERIAL AND METHODS This series included 15 feet operated on in 13 children from 1980 to 2003. The deformity to be corrected was a residual cavus after surgery for congenital talipes equinovarus (five feet), plantar and medial dislocation of the navicular bone on an acquired equinovarus in non-walking children (three feet), planovalgus with major forefoot abductus in non-walking children (four feet). Among the 13 children in this series, five did not walk (seven feet) and underwent surgery because of skin wounds caused by protrusion of the head of the talus and serious mechanical problems (shoes, ortheses). Mean age at operation was 8.5 years (range 2-16 years). The surgical procedure was part of an overall strategy combining use of ortheses, physiotherapy, and medical management. For congenital equinovarus with residual cavus, naviculectomy was performed after the usual technique for equinovarus when the navicular bone was dislocated above the medial tarsal and prevented reduction of the cavus. After extraperiosteal release, resection of the navicular bone enabled correction of the cavus. The lateral column had to be shortened in order to avoid adductus subsequent to medial-lateral length discrepancy. The same surgical technique was used for acquired equinovarus except that the navicular bone was displaced medially and above the talus. The lateral column had to be shortened. Standard procedures were applied for congenital convex feet before naviculectomy when there was major forefoot abductus after medial tarsal release and tendon lengthenings. The lateral column was not shortened since it was already too short. For planovalgus with forefoot abductus, naviculectomy was combined with release of the calcaneocuboid joint. Fibular tendons were lengthened. RESULTS Mean follow-up was two years five months (range 5 months-12 years 6 months). For the talipes equinovarus feet, the Méary Toméno angle was 24.4 degrees on average preoperatively and 5 degrees at last follow-up, giving a mean gain of 19.4 degrees . For congenital convex feet, the M5-lateral calcaneal border angle was 29.7 degrees on average preoperatively and 11.7 degrees at last follow-up for a mean gain of 18 degrees . For the planovalgus feet with forefoot abductus, the M5-lateral calcaneal border angle was 32.7 degrees on average preoperatively and 12.2 degrees at last follow-up, for a gain of 20.5 degrees on average; the mean Méary Toméno angle was -30 degrees preoperatively and -3 degrees at last follow-up, for a mean gain of 27 degrees . CONCLUSION For carefully selected patients, naviculectomy performed in combination with other procedures can provide appropriate correction of severe midfoot deformities in children.
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Affiliation(s)
- P Laudrin
- Service de Chirurgie Orthopédique, Hôpital St Vincent de Paul, 74-82, avenue Denfert-Rochereau, 75014 Paris
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Abstract
We retrospectively reviewed the results of joint distraction and reconstruction in complex knee contractures in 6 patients with 9 knees. The circular Ilizarov fixator was used in all cases. Extensor mechanism alignment with frame in situ was performed in 4 cases and alignment of mechanical axis of the lower limb was done in 2. All patients had a mean total arc of movement of 79 degrees before operation; however, this was nonfunctional because of the degree of flexion contracture. Three of the 6 patients were nonambulant before surgery. After joint distraction and reconstruction, mean total arc of movement remained unchanged, but this was more functional with improvement in the mobility status. At an average follow-up of 53 months, the mean flexion contracture was 100 degrees (range, 0-70 degrees), with further flexion possible up to 90 degrees (range, 60-120 degrees). Four patients had no recurrence. All 6 patients were ambulant with or without orthosis. Rebound phenomenon with loss of achieved correction was observed in 2 patients. Four patients were quite satisfied with results of surgery. Realignment of the extensor mechanism and mechanical axis is an important part that needs to be addressed in flexion contractures of the knee. Proper preoperative planning and staged procedures reduce the risk of recurrence. A treatment protocol is proposed to help in planning and further management.
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Affiliation(s)
- Kailash L Devalia
- Paediatric Limb Reconstruction Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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Mallia Milanes G, Napolitano R, Quaglia F, Mazzarelli LL, Agangi A, Tessitore G, Sansone M, Simioli S, Maruotti GM, Martinelli P. Prenatal diagnosis of arthrogryposis. Minerva Ginecol 2007; 59:203-4. [PMID: 17505463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Lee Y, Choi H, Chang D, Eom K, Yoon J, Choi M, Lee K, Yeon S, Lee H, Won C, Lee H. Imaging diagnosis--perosomus elumbis in a Korean calf. Vet Radiol Ultrasound 2007; 48:30-1. [PMID: 17236356 DOI: 10.1111/j.1740-8261.2007.00199.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Youngwon Lee
- Department of Veterinary Radiology, College of Veterinary Medicine, Chungnam National University, Daejeon, Korea
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Holden S, Ahuja S, Ogilvy-Stuart A, Firth HV, Lees C. Prenatal diagnosis of Harlequin ichthyosis presenting as distal arthrogryposis using three-dimensional ultrasound. Prenat Diagn 2007; 27:566-7. [PMID: 17385787 DOI: 10.1002/pd.1727] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We describe a case of Harlequin Icthyosis where the main 2D and 3D ultrasound findings were digital contractures as opposed to the more commonly described severe facial dysmorphisms. A prenatal finding of distal arthrogryposis can therefore include harlequin icthyosis as a differential diagnosis, where 3D ultrasound may then disclose the facial features more commonly associated with the condition.
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Affiliation(s)
- Simon Holden
- Department of Medical Genetics, Addenbrooke's Hospital, Cambridge, UK
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Sanseverino MTV, de Souza CFM, Gissen P, Sordi AO, Magalhães JA, Schüler-Faccini L. Increased nuchal translucency in arthrogryposis, renal dysfunction and cholestasis (ARC) syndrome and discovery of a Portuguese specific mutation in the VPS33B gene. Ultrasound Obstet Gynecol 2006; 28:233-4. [PMID: 16758438 DOI: 10.1002/uog.2822] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Kołecka E, Niedzielski K, Lipczyk Z, Bik K, Kraska T, Golański G. [Feet deformation treatment in children with arthrogryposis multiplex congenita (AMC)--evaluation of the results]. Chir Narzadow Ruchu Ortop Pol 2006; 71:463-6. [PMID: 17585491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
In Arthrogryposis Multiplex Congenita (AMC) feet deformations are frequent. They have form of talipes equinovarus, or less frequently of plano-valgus. The study included influence of various surgical techniques on final result of foot treatment in arthrogryposis. The aim of the study was to analyse errors in classification and surgical technique influencing the final result. Between 1986 and 2004 21 AMC children were surgically treated. In all of the patients the disease was accompanied by heavy feet deformations: 38 talipes equinovarus deformations and 1 plano-valgus. Age of the treated children was between 7 months and 4 years. All feet required surgery. Follow-up period was 3 to 20 years, mean 12.5 years. During the follow-up examination the following elements were evaluated: foot appearance, gait mechanics, foot load level, wearing commercial shoes or orthopaedic equipment. Additionally radiography of feet in AP and lateral projection was performed. Posterior liberation was performed in 21 feet, peritarsal reposition in 18 feet. In case of 13 feet the primary correction was satisfactory. In the remaining 26 feet re-surgeries were necessary, including astrogolectomy in 9 feet. 13 good results were obtained--in which feet were properly loaded, adapted to common shoes and painless. 15 satysfying results were obtained--the feet required orthopaedic shoes; and 11 bad results, where temporary foot pain additionally occurred. Excessively conservative primary surgery in case of heavy foot deformations was a cause for multiple re-surgeries.
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Affiliation(s)
- Ewa Kołecka
- Klinika Ortopedii i Traumatologii, Instytut Centrum Zdrowia Matki Polki w Lodzi
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Vimercati A, Scioscia M, Burattini MG, Pontrelli G, Selvaggi LE. Prenatal diagnosis of Freeman–Sheldon syndrome and usefulness of an ultrasound fetal lip width normogram. Prenat Diagn 2006; 26:679-83. [PMID: 16715537 DOI: 10.1002/pd.1470] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Freeman-Sheldon syndrome (FSS) is a rare genetic condition with facial and joint abnormalities. Here we report the first case of prenatal diagnosis in a fetus with negative familial history for this syndrome. A chart of the fetal mouth length was generated and its usefulness verified. METHODS A cross-sectional study was carried out to derive standard charts for fetal lip lengths. The study population was made up of 371 fetuses between 15 and 38 weeks of gestation examined only once for this purpose. A statistical analysis previously recommended to derive normal ranges in fetal growth charts was employed. RESULTS A 34-year-old woman was referred at 28 weeks of gestation for polyhydramnios and clubfeet. A detailed scan confirmed those findings and showed joint contractures of hands, a severe microstomia with a 'whistling' mouth, and an H-shaped mark over the chin. FSS was suspected, though there was no family history for this genetic syndrome. After emergency delivery at 32 weeks, the syndrome was confirmed. The infant died two months later from pneumonia. Upon construction of a standard mouth length chart, it was found that the fetal lip width in this case of FSS was well below the 5th centile. CONCLUSION Here we present a standard chart for fetal lip width. We demonstrated its usefulness in cases with fetal face anomalies. Specific charts are fundamental for an objective assessment of the fetal parameters.
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Abstract
Eight patients with arthrogryposis multiplex congenita (amyoplasia type) (11 knees) with knee hyperextension deformity underwent quadricepsplasty and were analyzed during an average follow-up period of 11 years and 2 months. The results were clinically analyzed based on gait pattern, range of movement, and orthotic requirements. Joint congruency was evaluated by radiography according to the Leveuf Pais classification. A satisfactory result was the correction of the deformity, articular congruency, sufficient range of movement, adequate gait pattern and no need for orthosis. A satisfactory outcome occurred in five of the eight patients (eight knees). We considered an unsatisfactory result when any of these conditions occurred. Our experience demonstrated that the quadricepsplasty corrected the hyperextension deformity of the knee joint, improved function, gait pattern, and maintained the muscle power of the quadriceps.
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Affiliation(s)
- Patrícia M M B Fucs
- Orthopaedic Department, Santa Casa Medical School and Hospitals, Pavilhão 'Fernandinho Simonsen', São Paulo, Brazil
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Abstract
The purpose of this study was to evaluate the results of primary radical soft-tissue release of arthrogrypotic clubfeet in children less than 1 year of age. We performed a retrospective review of six patients (12 feet) who underwent radical release of clubfoot deformity. Primary surgery was performed at an average of 7.4 months and the average follow-up was 4.3 years. We graded our results using a modified functional clubfoot rating system. We had two excellent, four good, three fair and three poor results. Revision surgery was performed on one foot for residual equinus. All patients ambulated independently with orthoses. Our short-term results with primary radical release of clubfoot deformity in arthrogryposis in infants under 1 year of age have been very encouraging. Correction of hindfoot equinus is excellent, and the recurrence rate remains low. Salvage talectomy has not been necessary in this population of children.
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Affiliation(s)
- Roger F Widmann
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York 10021, USA.
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Abstract
BACKGROUND Fowler syndrome is characterized by hydranencephaly, brain stem and basal ganglion calcifications, a glomeruloid vasculopathy of the brain vessels, and a fetal akinesia deformation sequence with muscular hypoplasia. The natural progression of the ultrasonographic features of Fowler syndrome has never been described. METHODS Case report and review of the literature. RESULTS A primiparous woman with a negative ultrasound at 11 weeks of pregnancy was noted at 15 weeks to have fetal nuchal thickening, generalized skin edema, prominent lateral ventricles, akinesia with arthrogryposis, and pterygia. At 18 weeks, a cystic hygroma with facial edema, hypertelorism, and hydrocephaly were noted; the limb deformity was still evident. Within 1 week, the cystic hygroma regressed partially, but the hydrocephaly deteriorated. CONCLUSION The multiple ultrasonographic features of Fowler syndrome may not occur simultaneously and their severity may vary with gestational age.
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Affiliation(s)
- Ihab M Usta
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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Abstract
Bruck syndrome is an autosomal recessive connective tissue disorder combining features of osteogenesis imperfecta and arthrogryposis multiplex congenita. There are only few reports describing this rare syndrome of multiple fractures and joint contractures that is thought to be a subtype of osteogenesis imperfecta. We report the first case of prenatal diagnosis of this syndrome in a fetus at 23 weeks of gestation. Ultrasound findings included brachycephaly, retrognathia marked shortening and bowing of both femurs, bilateral fixed flexion of the elbows, bilateral fixed extension of the wrists and partially fixed flexion of the knees. The parents opted for termination of pregnancy. Macroscopic and radiologic examination of the aborted fetus confirmed the prenatal diagnosis, whereas morphological studies of the bone tissue found no hard evidence of osteogenesis imperfecta, probably due to the early stage of pregnancy and the heterogeneity of the syndrome itself.
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Affiliation(s)
- C Berg
- Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, Rheinische Friedrich-Wilhelms-Univeristät Bonn, Germany. christoph.
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Abstract
PURPOSE Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. It is commonly believed that bilaterally dislocated hips associated with joint contractures should not be reduced, because movement is satisfactory, while open reduction leads to poor results. This report presents our experience with surgical management of bilateral dislocation of hips in children with AMC. METHODS During the period 1990 to 2000, we performed open reduction on 8 hips of 4 children with AMC. The mean age at surgery was 23 months (range, 5-48 months). Open reduction and capsular plication without any bony procedure were performed in 4 hips (2 patients). De-rotation and varus osteotomy of the femur was performed in 4 hips, and Salter osteotomy of the innominate bone in 2 hips. The average acetabular index was 44 degrees, and the mean centreedge angle was -41 degrees preoperatively. RESULTS The average follow-up period was 4 years (range, 2-9 years). The average acetabular index and centre-edge angle were 19 and 18 degrees, respectively at the time of last follow-up. All children could walk without support. One child required re-opening for redislocation of hip joint. The clinical results were good in 6 hips and fair in 2 hips, according to Severin's and McKay's classifications. CONCLUSION Our experience shows that open reduction for bilateral dislocation of hips in children with AMC is a suitable option with generally good results. Surgery performed at earlier age gives the best functional outcome.
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Affiliation(s)
- S Asif
- Division of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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Alimkhanova RS. [Clinical and X-ray aspects in childhood arthrogryposis pathology]. Vestn Rentgenol Radiol 2004:50-4. [PMID: 15587884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
This paper gives a retrospective analysis of clinical and X-ray changes in arthritic influenza deformity in relation to age, starting from neonatality. All the data presented are of interest since this disease occurs extremely rarely, has a multiple lesion pattern, and leads to disability and lowered social adaptation.
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Mielnik-Błaszczak M, Borowska M. Arthrogryposis multiplex congenita (AMC)--case report. Ann Univ Mariae Curie Sklodowska Med 2003; 57:437-41. [PMID: 12898876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
AMC (which can be also described as fetal muscle cicatrisation) is a term describing the presence of various arthrogenic contractures at the moment of birth, limiting, to a certain degree, the range of joints mobility. The incidence of the disease is low--1 per 3,000 births and it is usually not determined genetically. In a 12-year-old patient treated in Paedodontic Dentistry Department of the Medical University of Lublin the contractions were observed in elbow joints, wrist joints and ankle joints. Dental examination revealed microgenia, limited mobility in temporo-mandibular joints and delayed teething. DMF mean value of permanent teeth was 4. Earlier the patient has not undergone any dental treatment. The conservative and orthodontic treatment applied was difficult due to limited mandible abduction (2-3 cm) and limited lateral movements. Children and adolescents with such diseases should undergo intensive prophylactic procedures because their dental treatment is very complicated.
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Murphy JC, Neale D, Bromley B, Benacerraf BR, Copel JA. Hypoechogenicity of fetal long bones: a new ultrasound marker for arthrogryposis. Prenat Diagn 2002; 22:1219-22. [PMID: 12478637 DOI: 10.1002/pd.492] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To demonstrate osteopenia associated with arthrogryposis. METHODS & RESULTS We describe 3 cases of fetal arthrogryposis seen prenatally with the sonographic feature of severe hypoechogenicity of the long bones. This manifestation of presumed osteopenia is thought to represent osteoporosis secondary with absent fetal movement. CONCLUSION We describe hypoechogenicity of the fetal bones as a new sonographic feature of arthrogryposis.
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Affiliation(s)
- June C Murphy
- Department of Obstetrics & Gynecology, Yale University School of Medicine, USA
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Abstract
Arthrogryposis, is the occurrence of joint contractures of variable etiology that start prenatally. Arthrogryposis may result from neurologic deficit, neuromuscular disorders, connective tissue abnormalities, amniotic bands, [figure: see text] or fetal crowding. Arthrogryposis may result from no apparent hereditary causes (neuropathic, for example) or may be the result of hereditary factors (myopathic form, for example). Ultrasound diagnosis depends on observation of scant or absent motion of fetal extremities. Prognosis depends on the specific etiology of the contractures.
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Eisenhut M, Weindling M, Fryer A. Amyoplasia associated with a balanced de novo insertion of a segment of the long arm of chromosome 5 into chromosome 2. Am J Med Genet 2002; 107:337-9. [PMID: 11840493 DOI: 10.1002/ajmg.10171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Madazli R, Tüysüz B, Aksoy F, Barbaros M, Uludağ S, Ocak V. Prenatal diagnosis of arthrogryposis multiplex congenita with increased nuchal translucency but without any underlying fetal neurogenic or myogenic pathology. Fetal Diagn Ther 2002; 17:29-33. [PMID: 11803213 DOI: 10.1159/000048002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Arthrogryposis multiplex congenita is a general term for congenital multiple joint contractures, the aetiology of which is variable. Prenatal diagnosis is usually based on the detection of diminished fetal movements and joint contractures on ultrasound. There are also reports of early diagnosis of arthrogryposis in the first and early second trimester by detection of subcutaneous oedema. We report another case of arthrogryposis multiplex congenita with increased nuchal translucency and scoliosis diagnosed by ultrasonography at 15 weeks of gestation. The pregnancy was terminated at the request of the parents. Post-mortem examination revealed that it was not associated with fetal myopathy or neuropathy. Multiple joint contractures with increased nuchal translucency without any underlying fetal neurogenic and myogenic pathology may be a distinct form of arthrogryposis multiplex congenita.
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Affiliation(s)
- Riza Madazli
- Department of Obstetrics and Gynaecology, Cerrahpasa Medical Faculty, University of Istanbul, Turkey.
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Choi IH, Yang MS, Chung CY, Cho TJ, Sohn YJ. The treatment of recurrent arthrogrypotic club foot in children by the Ilizarov method. A preliminary report. J Bone Joint Surg Br 2001; 83:731-7. [PMID: 11476315 DOI: 10.1302/0301-620x.83b5.11019] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Between 1994 and 1997 we used the Ilizarov apparatus to treat 12 recurrent arthrogrypotic club feet in nine patients with a mean age of 5.3 years (3.2 to 7). After a mean of three weeks (two to seven) for correction of the deformity and 1.5 weeks (one to four) for stabilisation in the apparatus, immobilisation in a cast was carried out for a mean of 14 weeks (7 to 24). The mean follow-up period was 35 months (27 to 57). Before operation there were one grade-II (moderate), eight grade-III (severe) and three grade-IV (very severe) club feet, according to the rating system of Dimeglio et al. After operation, all the club feet except one were grade I (benign) with a painless, plantigrade platform. Radiological assessment and functional evaluation confirmed significant improvement. Two complications occurred in one patient, namely, epiphysiolysis of the distal tibia and recurrence of the foot deformity. These results suggest that our proposed modification of the Ilizarov technique is effective in the management of recurrent arthrogrypotic club foot in young children.
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Affiliation(s)
- I H Choi
- Seoul National University Children's Hospital and Clinical Research Institute, Korea
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Paladini D, Tartaglione A, Agangi A, Foglia S, Martinelli P, Nappi C. Pena-Shokeir phenotype with variable onset in three consecutive pregnancies. Ultrasound Obstet Gynecol 2001; 17:163-165. [PMID: 11251928 DOI: 10.1046/j.1469-0705.2001.00246.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The Pena-Shokeir phenotype represents an autosomal recessive syndrome characterized by neurogenic arthrogryposis, facial anomalies and pulmonary hypoplasia. Prenatal diagnosis of this disease has been reported prospectively and in cases with positive family history. We describe here a patient who has had three consecutive pregnancies affected by the Pena-Shokeir syndrome. In these pregnancies, the onset of the arthrogryposis varied between the 12th and the 18th week of gestation. Therefore, the possibility of a variable chronological development of the main diagnostic feature of the syndrome, arthrogryposis, has to be taken into proper consideration while counseling families with a positive history for the Pena-Shokeir phenotype.
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Affiliation(s)
- D Paladini
- Fetal Cardiology Unit, Department of Gynecology and Obstetrics, University Federico II of Naples, Naples, Italy.
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Witters I, Moerman PH, Van Assche FA, Fryns JP. Cystic hygroma colli as the first echographic sign of the fetal akinesia sequence. Genet Couns 2001; 12:91-4. [PMID: 11332983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
We report first trimester cystic hygroma colli with subsequent resolution and development of a fetal akinesia deformation sequence. Neuropathological examination of the brain showed intra- and extracellular white matter edema while spinal cord, peripheral nerves and muscles were normal. Hygroma colli as the first echographic sign of subsequent severe fetal akinesia sequence without muscular dystrophy as seen in the Lethal Multiple Pterygium syndrome has not been previously reported.
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Affiliation(s)
- I Witters
- Department of Obstetrics and Gynecology, University of Leuven, Belgium
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Abstract
Forty-six patients (25 male and 21 female) with arthrogryposis multiplex congenita who were seen at the Alfred I. duPont Hospital for Children between the years 1940 and 1997 were evaluated to assess the prevalence and patterns of scoliosis and the long-term results after both nonsurgical and surgical treatment methods. We found the prevalence of scoliosis to be 65.9% (32 of 46 patients). A single thoracolumbar curve was the predominant curve pattern. No congenital curve types or vertebral anomalies were seen in our group of patients. In the nonsurgical group, the mean curve was <30 degrees at follow-up. In the surgical group, the mean primary curve before spinal arthrodesis was 78.5 degrees. Three patients in the surgical group who were nonambulators have become household ambulators at the most recent follow-up. We recommend bracing in patients who are ambulators and have a curve of <30 degrees. Combined anterior and posterior spinal arthrodesis gave the best results.
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Affiliation(s)
- W Yingsakmongkol
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Abstract
BACKGROUND The Cerebro-Ocular-Facio-Skeletal (COFS) syndrome is an autosomal recessive condition characterized by neurogenic arthrogryposis, severe facial anomalies and brain maldevelopment. We describe here the first case of prenatal diagnosis of this syndrome in a 21-week fetus. CASE The woman was referred to our unit on suspicion of fetal microphthalmia. On trans-abdominal ultrasound, severe bilateral microphthalmia was confirmed. Micrognathia, multiple joint contractures and rockerbottom feet were also detected. On the basis of these findings, the diagnosis of COFS syndrome was hypothesized. After termination of pregnancy, necropsy confirmed all prenatal findings. Histology showed severe architectural derangement of the eye and brain together with cerebellar anomalies compatible with the diagnosis of COFS syndrome. CONCLUSIONS To the best of our knowledge, this represents the first case of prenatal diagnosis of COFS syndrome. This case demonstrates the feasibility of such a diagnosis by ultrasound and identifies the malformations already present and detectable at mid-gestation.
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Affiliation(s)
- D Paladini
- Department of Gynecology and Obstetrics, University Federico II of Naples, Italy
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