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DOI: 10.1148/rg.263055113
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RadioGraphics 2006;26:811-829
© RSNA, 2006

EDUCATION EXHIBIT

Obstetric US: Watch the Fetal Hands1

Françoise Rypens, MD, Josée Dubois, MD, Laurent Garel, MD, Jean-Christophe Fournet, MD, Jacques L. Michaud, MD and Andrée Grignon, MD

1 From the Department of Radiology (F.R., J.D., L.G., A.G.), Department of Pathology (J.-C.F.), and Division of Medical Genetics (J.L.M.), Hôpital Ste-Justine and Université de Montréal, 3175 Côte Ste-Catherine, Montreal, Quebec, Canada H3T 1C5. Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received May 6, 2005; revision requested June 3 and received June 24; accepted July 20. All authors have no financial relationships to disclose. Address correspondence to F.R. (e-mail: francoise_rypens{at}ssss.gouv.qc.ca).

Hand anomalies are difficult to diagnose and are often overlooked during prenatal ultrasonography (US). The spectrum of malformations varies from subtle finger deformities to the complete amputation of limbs. Malformations of the hand can be classified, according to the predominant anomaly, among the following categories: alignment abnormalities (clenched hand, camptodactyly, clinodactyly, hypokinesia, clubhand, phocomelia), thumb anomalies, abnormal size (macrodactyly, trident hand), abnormal echogenicity (abnormal calcifications), abnormal number (polydactyly, syndactyly, ectrodactyly), and constriction band sequence. A fetal hand anomaly has important diagnostic and prognostic implications as well as functional consequences. Malformation may be isolated but often is associated with a syndrome or karyotype anomaly. Classification and characterization of the anomaly help to narrow the differential diagnosis: Some malformations (clenched hand, hitchhiker thumb) are highly suggestive of a specific diagnosis. The detection of a fetal hand malformation warrants a complete work-up, including complete fetal and cardiac US examinations, as well as genetic counseling to determine whether familial inquiry and karyotype analysis are necessary.

© RSNA, 2006


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Invited Commentary
Teresita L. Angtuaco
RadioGraphics 2006 26: 830-831. [Full Text] [PDF]





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