Case of the Week # 73

Pavel Vlašin, MD, Pavel Eliáš, MD*

May 17-30, 2002

Centrum prenatálni diagnostiky, Brno, and *FN Hradec Králové, Czech Republic

This 27-year-old G2 P1 was sent for ultrasound screening  at 17 weeks. The biochemical screening was negative

The following are images from the first scan:

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A genetic amniocentesis was performed that revealed a normal karyotype 46 XY.

A second ultrasound scan was performed at 21 week

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The humerus

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The femur

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What is (are) the finding(s), and the name of the condition ?

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Answer

This 27-year-old G2 P1 was sent for ultrasound screening  at 17 weeks. The biochemical screening was negative

The following are images from the first scan. They demonstrate brachycephaly and moderately large 3rd ventricle

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as well as nuchal edema:

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A genetic amniocentesis was performed that revealed a normal karyotype 46 XY.

A second ultrasound scan was performed at 21 week. Hypotelorism and a depressed nasal bridge are seen.

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The most important findings is at the level of the epiphysis of the humerus

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and of the femur. In both bones small calcifications are seen.

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The major finding in this case is thus the presence of small calcifications in the epiphysis. There are numerous conditions associated with epiphyseal calcifications. This is the list in OMIM:

271665 Spondylometaepiphyseal dysplasia, short limb-hand type
*120140 Collagen, type ii, alpha-1; col2a1
#215100 Rhizomelic chondrodysplasia punctata, type 1; rcdp1
215140 Chondrodystrophy, hydropic and prenatally lethal type
#221770 Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy; plosl
*118650 Chondrodysplasia punctata, autosomal dominant
300800 Albright hereditary osteodystrophy; aho
#215045 Chondrodysplasia, Blomstrand type
#222600 Diastrophic dysplasia
#241500 Hypophosphatasia, infantile
#313400 Spondyloepiphyseal dysplasia tarda, x-linked
601668 Spondyloepimetaphyseal dysplasia with abnormal dentition

In this case the fetus had Chondrodysplasia punctata (see also Chondrodysplasia punctata)

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