Presentation
Abstract The clinical and pathologic findings in two male siblings with congenital myopathy are presented. The pathologic changes in both cases were identical to those seen in progressive muscular dystrophy. [pediatrics.aappublications.org]
With this goal in mind, the editors have taken great care to ensure that the presentation of complex clinical information is at once scientifically accurate, patient oriented, and accessible to readers without a medical background. [books.google.com]
The most common type of nemaline rod myopathy presents in the infantile stage with 42% of patients presenting in the neonatal period. [6] While there has been an association with polyhydramnios, decreased fetal movements, and an abnormal fetal presentation [emedicine.medscape.com]
Vertebral changes are often present (Figure 166.3). Figure 166.3. Stuve-Widerman syndrome. [pediatricneuro.com]
The subject presented with pronounced mental retardation, was slightly underweight, and had facial dymorphism, and the typical alterations at the level of the thumbs (short, wide and radially deviated) and toes. [moh-it.pure.elsevier.com]
Gastrointestinal
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Constipation
Common side effects include a higher risk of respiratory tract infection and constipation. There may also be a risk of bleeding and kidney problems. [medicalnewstoday.com]
Constipation. 8. Feeding difficulties are common in early infancy and may persist through childhood. [now.aapmr.org]
Cardiovascular
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Tachycardia
During the first 3 days after surgery, an urticarioid reaction of unknown cause was observed, associated with hyperpiressia, periorbital edema and tachycardia, which resolved after specific pharmacological treatment. [scoliosisjournal.biomedcentral.com]
Musculoskeletal
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Coxa Vara
The changes due to bone remodeling, as a result continuous muscle contraction are: flat face; hypognathium; pectus excavatum; pectus carinatum; bowing or external rotation of the femora, coxa vara, or valga; dysplasia or subluxation of the hips; retrocurvation [pediatricneuro.com]
Skin
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Skin Atrophy
clubfoot or talipes equinovarus), skin atrophy and replacement of limb muscles with fibrous tissue. AMC is not a sui generis disease, but rather a descriptive term that signifies multiple congenital contractures. [medical-dictionary.thefreedictionary.com]
Neurologic
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Confusion
Yet, the existing medical literature on arthrogryposis is sparse and often confusing. [books.google.com]
Confusion has arisen because the term was used as a diagnosis. The term is descriptive, and the presence of congenital contractures only indicates a clinical sign with multiple underlying causes. [mhmedical.com]
Target fibers may be confused with central cores, which occur in a congenital myopathy-central core myopathy. In the EMG, large motor units appear as polyphasic or giant motor unit potentials. Denervated muscle is overexcitable. [neuropathology-web.org]
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Flaccid Paralysis
Most severe and common Poorest prognosis Infancy - decreased fetal mvmt in utero Impairments: - Hypotonia - Symmetrical flaccid paralysis - Respiratory. complications - No head control - weakness in proximal mm of neck, trunk, pelvic, and shoulder girdles [quizlet.com]
Treatment
Brace treatment remains controversial as spine deformities in arthrogryposis tend to resist brace treatment and progress rapidly in most cases. [scoliosisjournal.biomedcentral.com]
Knee Contractures Treatment operative soft tissue releases (especially hamstrings) indications flexion contracture 30 degrees best performed early (6-9 months of age) perform before hip reduction to assist in maintenance of reduction femoral angulation [orthobullets.com]
Based on this evaluation, we will recommend a treatment plan and review it with you and your child. Your child has therapy Monday to Saturday, typically in the morning and afternoon. [seattlechildrens.org]
/Management [ edit ] First important to determine the cause Influences prognosis, recurrence risk, and treatment Definite diagnosis may not be possible in neonatal period Important to separate neurological from non-neurological causes MRI study for infants [en.wikibooks.org]
The most common treatments for arthrogryposis are: Open Reduction Open reduction is a surgery that returns a dislocated or misshapen joint to its proper place. [gillettechildrens.org]
Prognosis
Prognosis depends on the specific etiology of the contractures The incidence of abnormal joint contractures and other accompanying malformations in eight patients observed with three-dimensional ultrasonography are described [elsevier.es]
Prognosis Ventilator dependence in the neonatal period is associated with a poor prognosis. Prognosis also depends on natural history and the patient’s response to therapy. [boneandspine.com]
Prognosis Prognosis depends on the underlying cause but most have a normal lifespan. If, however, there is a central nervous system problem in addition, about half of patients die in the first year. [patient.info]
Prognosis - Arthrogryposis Treatment - Arthrogryposis Resources - Arthrogryposis [checkorphan.org]
Etiology
Abstract Arthrogryposis, or multiple congenital contractures, is the occurrence of joint contractures of diverse etiology in the prenatal period. [elsevier.es]
The etiology of arthrogryposis (multiple congenital contracture). Clin Orthop Relat Res. 1985;(194):15-29. Kowalczyk B, Feluś J. Arthrogryposis: an update on clinical aspects, etiology, and treatment strategies. Arch Med Sci. 2016 Feb 1;12(1):10-24. [now.aapmr.org]
We treat all levels of SCI including ventilator dependence, due to traumatic or non-traumatic etiology, complete or incomplete at any level, and comorbidities including brain injury, polytrauma, fractures, halo fixation, neurogenic bowel/bladder, DVT, [seattlechildrens.org]
Arthrogryposis (Multiple Congenital Contractures): Diagnostic Approach to Etiology, Classification, Genetics, and General Principles. Eur J Med Genet 2014;57:464-472. Filges I, Hall JG. [rarediseases.org]
Table 674-1 ASSOCIATED ETIOLOGIES OF ARTHROGRYPOSIS ARTHROGRYPOSIS DUE TO NERVOUS SYSTEM DISORDERS DISTAL ARTHROGRYPOSIS SYNDROMES PTERYGIUM SYNDROMES MYOPATHIES ABNORMALITIES OF JOINTS AND CONTIGUOUS TISSUE SKELETAL DISORDERS INTRAUTERINE AND MATERNAL [clinicalgate.com]
Epidemiology
Introduction Nonprogressive congenital disorder involving multiple rigid joints (usually symmetric) leading to severe limitation in motion Epidemiology incidence 1:3000 live births Mechanism symmetry of contractures due to immobilization in utero neurogenic [orthobullets.com]
"Arthrogryposis multiplexa congenita: An epidemiologic study of nearly 9 million births in 24 EUROCAT registers". European Journal of Obstetrics & Gynecology and Reproductive Biology. 159 (2): 347–50. doi : 10.1016/j.ejogrb.2011.09.027. [en.wikipedia.org]
Arthrogryposis Epidemiology The occurrence of AMC is rather rare. Only 1 out of 3000 people gets affected by this disorder. Amyoplasia is the most common form of this disease and is observed in nearly 43% of all reported cases. [primehealthchannel.com]
Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries. Psychol Med 2017. 47: 531-542. [fsjd.org]
Epidemiology Arthrogryposis is a rare condition. Some authors say the overall prevalence is one in 3000 and others say it is one in 11000-12000 among European live births. [monsterologist.blogspot.com]
Pathophysiology
Amyoplasia, the most common type of arthrogryposis: the pathophysiology for good outcome. Pediatr 1996:97(2):225–31. [ Pubmed ] Brown LM, Robson MJ, Sharrard WJ. The pathophysiology of arthrogryposis multiplex congenita neurologica. [ijcasereportsandimages.com]
Fibrosis What is basic pathophysiological mechanism for AMC? Multiple joint contractures - due to lack of fetal movement mobility and self-care skills Type 1 AMC: clinical manifestations? 1. Flexed and dislocated hips 2. Extended knees 3. [quizlet.com]
[…] congenital disorder involving multiple rigid joints (usually symmetric) leading to severe limitation in motion Epidemiology incidence 1:3000 live births Mechanism symmetry of contractures due to immobilization in utero neurogenic (90%) myopathic (10%) Pathophysiology [orthobullets.com]
Pathophysiology of Arthrogryposis Decreased fetal movements or fetal akinesis has been suggested to be the major contributory cause. The decrease in activity could be due to fetal abnormalities or maternal disorders like. [boneandspine.com]
Patho-anatomy/physiology The pathophysiology is related to the specific type of arthrogryposis. Exact mechanisms are not well understood in some subtypes of arthrogryposis. [now.aapmr.org]
Prevention
Arthrogryposis multiplex congenita, AMC Symptoms - Arthrogryposis Prevention - Arthrogryposis Genetic advice can be essential to prevent arthrogryposis. [checkorphan.org]
However some reason prevents the fetus movement leading to contracture of joints and muscles. [diseasespictures.com]
SMA cannot be prevented, but prospective parents can request genetic testing if they may be carriers. Types There are different types of SMA. [medicalnewstoday.com]
Prevention Genetic advice may be essential to prevent arthrogryposis. Extrinsically derived contractures have a low recurrence risk but the recurrence risk for intrinsically derived contractures depends on the aetiology. [patient.info]
Prevention There is no way to prevent spinal muscular atrophy. However, genetic counseling is crucial so that parents can make informed decisions about having children. [healthofchildren.com]