Presentation
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]
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]
Vertebral changes are often present (Figure 166.3). Figure 166.3. Stuve-Widerman syndrome. [pediatricneuro.com]
At present at least nine different types of amyoplasia are recognized. [scoliosisjournal.biomedcentral.com]
Summary Two unrelated patients with severe arthrogryposis multiplex congenita (AMC) who died perinatally, are presented. [link.springer.com]
Entire Body System
- Developmental Disorder
Coordination Disorder Autism Spectrum Disorder Asperger's Syndrome High-Functioning Autism Autism Pervasive Developmental Disorder Otherwise Non-Specified Learning Disabilities Dysgraphia (difficulty with the motoric act of handwriting) Dyslexia ADD/ [handwriting-solutions.com]
Cognition/behavior: Cognition is typically normal if there is no underlying neurologic, chromosomal or developmental disorder. 2. Ambulation: Walking is often delayed until to 2-5 years old. 3. [now.aapmr.org]
Musculoskeletal
- Muscle Weakness
Muscular dystophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue. [ipass.org.uk]
Clinical findings are hypotonia, congenital hip dislocation, torticollis, contractures, arthrogryposis, distal laxity in the neonatal period, and generalized, slowly progressive muscle weakness, including mild facial weakness. [medlink.com]
Children who have classic arthrogryposis frequently experience muscle weakness accompanied by joint stiffness. Syndromic Arthrogryposis This type affects internal organs, along with muscles and joints. [gillettechildrens.org]
- Flexion Contracture
flexion. Flexion contracture of the elbow is less commonly observed. [slideshare.net]
Other positive prognostic factors for independent walking were active hips and knees, hip flexion contractures of less than 20 degrees and knee flexion contractures less than 15 degrees without severe scoliosis. [monsterologist.blogspot.com]
If a flexed knee is neglected, postural hip flexion contractures are likely to ensue. Combined contracture in both hips and knees is not compatible with good gait. [orthopaedicsone.com]
Teratologic Hip Subluxation & Dislocation Introduction present in 68-80% of patients with arthrogryposis Treatment Knee Contractures Treatment operative soft tissue releases (especially hamstrings) indications flexion contracture >30 degrees best performed [orthobullets.com]
Hip and knee flexion, shoulder adduction, elbow extension, wrist and finger flexion contractures are common. 7 Joint fusion-synostosis or soft tissue contractures. Pterygiumskin webs in between joints. Muscle atrophy. [now.aapmr.org]
- Hyperlaxity
Overview In this article, the author discusses Ullrich congenital muscular dystrophy (UCMD), a collagen VI–related myopathy, which is characterized by proximal joint contractures, distal hyperlaxity, and normal intelligence. [medlink.com]
Nevertheless, proximal muscle weakness with distal hyperlaxity is characteristic for UCMD, especially together with proximal joint contracture. [journals.plos.org]
Myopathy With Fiber-Type Disproportion, Nemaline Myopathy, Cap Myopathy AD,AR 100 27 of 27 TRIP4 Congenital Muscular Dystrophy, Spinal Muscular Atrophy With Congenital Bone Fractures, Congenital Muscular Dystrophy-Respiratory- Skin Abnormalities- Joint Hyperlaxity [igenomix.es]
- Joint Stiffness
Arthrogryposis multiplex congenita (AMC) is a condition that leads to a limited range of joint motion. Children born with AMC often experience joint stiffness (also known as joint contracture) and muscle weakness. [gillettechildrens.org]
Workup
X-Ray
- Atelectasis
In the immediate postoperative, pulmonary complications occurred with lung atelectasis, cough with haemoptysis and severe dyspnea: prompt treatment in ICU led to complete resolution of symptoms in 10 days. [scoliosisjournal.biomedcentral.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]
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]
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Prognosis
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 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 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]
Etiology Arthrogryposis is multifactorial in etiology. Factors liable to produce immobility of the fetus in-utero may contribute to congenital contractures. [orthopaedicsone.com]
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]
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]
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]
"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 It may occur to some extent in 1 in 3,000 to 1 in 5,000 live births. [ 3 ] The condition is usually detected at birth or before by ultrasound examination. It is often secondary to other conditions. [patient.info]
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]
Anything that prevents normal movement of a baby in the womb will lead to contracture, where a joint does not have a full range of movement. [ipass.org.uk]