4. Upper limb
Adactyly----absence of finger
Amelia----absence of limbs
Brachydactyly----short phalanges
Brachymesophalangy---short middle
phalanges
5.
6. Sprengel shoulder
This deformity consist of an abnormally high
scapula .the deformity is due to failure of the
shoulder girdle to descend from its embryonic
position in the neck ,a process which is normally
completed by the end of the third fetal month .the
lesion is usually unilateral though it may b
bilateral.
Failure of normal descent of scapula from initial
mid-cervical position to final thoracic position.
Descent should occur between sixth and eight
weeks gestation
7.
8.
9.
10.
11. Whenever u see sprengel
shoulder deformity always look
for
Cervical spina bifida ,klippel feil anamoly
,cervical ribs and other ribs lesions, scoliosis.
12. Congenital anomalies Radius and
ulna
Radial defects are much more common than
ulnar and may occur in isolation or as part of
major syndromes
May occur with
Ectodermal dysplasia
Holt oram syndrome
Fanconi,s syndrome
thrmbocytopenia
20. The lower limb
DDH (developmental dysplasia of hip joint)
Proximal femoral focal deficiency
Idiopathic coxa vara of childhood
21. DDH
THIS is very important condition because
success in its treatment depend upon early
recognition
22. DDH
It is unilateral but both hips may b involved,
female are more commonly affected
23. DDH
Absolute indication for imaging the hip joint
Family hx of congenital dislocation of hip
Neonatal hip instability
Likb shortening
Limitation of hip abduction in flexion
25. ultrasound
Screening period >2weeks and upto 4 to 6
months of age
Examination impractical beyond 4 to 6 months
of age
26. Ultrasound method
The image is obtained with the child on
his/her side with the hip slightly flexed the
tranducer is parallel to the illium and the
image obtained in coronal plane.
The measurement of Graf angles may b made
in the assessment of hip dysplasia to
determine the degree of dysplasia.
33. Plain film
AP pelvic radiograpgh :>4 – 6 months of age
Not reliable first 3 months of life
Actebular angle greater than 3o degree
strongly suggests dysplasia
36. Hilgenreiner line
The Hilgenreiner line is a line drawn
horizontally through the inferior aspect of both
triradiate cartilages. It should be horizontal,
but is mainly used as a reference for Perkin
line and measurement of the acetabular
angle.
37. Perkin line
The Perkin line is drawn perpendicular to
Hilgenreiner line, intersecting the lateral most
aspect of the acetabular roof.
38. Acetabular angle
The acetabular angle is formed by the
intersection between a line drawn tangential
to the acetabular roof and Hilgenreiner line,
forming an acute angle..
39. Shenton line
The Shenton line is drawn along the inferior
border of the superior pubic ramus and should
continue laterally along the inferomedial
aspect of the proximal femur as a smooth line.
If there is a superolateral migration of the
proximal femur due to DDH then this line will
be discontinuous.
