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    This document provides descriptions of five congenital disorders or developmental variations: 1) Congenital radioulnar synostosis, which is the failure of the radius and ulna to separate during development, affecting pronation and supination. 2) Ulna minus variant, where the ulna is shorter than normal, which can be associated with wrist problems. 3) Madelung's deformity, a wrist anomaly caused by abnormal growth, causing wrist curvature and pain. 4) Syndactyly, the fusion of adjacent digits, commonly involving specific finger pairs. 5) Acro-osteolysis, a progressive bone loss in the fingers or toes, often associated with circulation or genetic problems

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    This document provides descriptions of five congenital disorders or developmental variations: 1) Congenital radioulnar synostosis, which is the failure of the radius and ulna to separate during development, affecting pronation and supination. 2) Ulna minus variant, where the ulna is shorter than normal, which can be associated with wrist problems. 3) Madelung's deformity, a wrist anomaly caused by abnormal growth, causing wrist curvature and pain. 4) Syndactyly, the fusion of adjacent digits, commonly involving specific finger pairs. 5) Acro-osteolysis, a progressive bone loss in the fingers or toes, often associated with circulation or genetic problems

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    This document provides descriptions of five congenital disorders or developmental variations: 1) Congenital radioulnar synostosis, which is the failure of the radius and ulna to separate during development, affecting pronation and supination. 2) Ulna minus variant, where the ulna is shorter than normal, which can be associated with wrist problems. 3) Madelung's deformity, a wrist anomaly caused by abnormal growth, causing wrist curvature and pain. 4) Syndactyly, the fusion of adjacent digits, commonly involving specific finger pairs. 5) Acro-osteolysis, a progressive bone loss in the fingers or toes, often associated with circulation or genetic problems

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    Download as docx, pdf, or txt
    26 views3 pages

    Self-Directed Learning

    Uploaded by

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    This document provides descriptions of five congenital disorders or developmental variations: 1) Congenital radioulnar synostosis, which is the failure of the radius and ulna to separate during development, affecting pronation and supination. 2) Ulna minus variant, where the ulna is shorter than normal, which can be associated with wrist problems. 3) Madelung's deformity, a wrist anomaly caused by abnormal growth, causing wrist curvature and pain. 4) Syndactyly, the fusion of adjacent digits, commonly involving specific finger pairs. 5) Acro-osteolysis, a progressive bone loss in the fingers or toes, often associated with circulation or genetic problems

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    CHIR12007

    Clinical Assessment and Diagnosis


    Portfolio Exercises Week 8

    Self-directed learning:

    The following conditions are congenital disorders or alterations in development that may
    have clinical consequences and may mimic other conditions.
    Investigate the following conditions. Include a description of the condition, relevant clinical
    history, any associated clinical findings, associated clinical or systemic features and any
    additional information you feel may be important as a chiropractor. (also incl reference(s))

    A. Congenital Radioulnar Synostosis

    · Refers to the failure of segmentation of the


    adjacent radius and ulna
    · Caused by the failure of separation of the
    fused cartilaginous precursors of the radius
    and ulna during the 7th week of gestation
    · Affects supination and pronation
    movements of the elbow joint (flexion and
    extension of unaffected)
    · Does however potentially create excessive
    strain on the shoulder and wrist joint

     Over half of cases are bilateral


     Mild deformities can be compensated well through movement of adjacent joints
     To avoid strain activity modification, occupational therapy and ergonomic work places are
    recommended

    Tsai, J. (2017). Congenital radioulnar synostosis. Radiology Case Reports, 12(3), 552-554.


    https://doi.org/10.1016/j.radcr.2017.03.011
    B. Ulna Minus Variant

    · Refers to the relative lengths of the distal


    articular surface of the radius and ulna, in this
    case the ulnar projects more proximally
    compared to the radius
    · Can be caused by trauma or mechanical issues
    (fracture or surgical shortening), it may also be
    congenital (Madelung deformity)
    · Associated with Kienbocks disease (avascular
    necrosis of lunate) and ulnar impingement
    (caused by shortened distal ulna impinging on
    distal radius proximal to sigmoid notch of
    radius)

     Ulnar variance changes with wrist position (more


    positive with maximum forearm pronation and negative
    with maximum forearm supination) and increases
    significantly during a firm grip

    Radiopaedia. (2018). Ulnar Variance. Retrieved from https://radiopaedia.org/articles/ulnar-variance

    C. Madelung’s Deformity

    · Congenital anomaly of the wrist caused by asymmetric


    growth at the distal radial physis secondary to a partial
    ulnar side arrest
    · Characterised by ulnar and palmer curvature of the
    distal radius, positive ulnar variance and proximal
    subsidence of the lunate
    · In females more than males and typically both wrists

     Stiffness, pain and extensor tendon ruptures have been reported


     Can usually be viewed exteriorly (without x-ray)

    Ghatan, A. C., & Hanel, D. P. (2013). Madelung Deformity. Journal of the


    American Academy of Orthopaedic Surgeons, 21(6), 372-382.
    http://dx.doi.org.ezproxy.cqu.edu.au/10.5435/JAAOS-21-06-372

    D. Syndactyly

    · Congenital anomaly where there is


    fusion of adjacent digits due to failure
    to separate of developing phalanges
    during organogenesis
    · More common in males (2x)
    · Can be bilateral, symmetrical of asymmetrical

     Commonly involves interspaces between


    middle and ring finger, ring and little finger
    (can also happen between thumb and index
    or index and middle)
     Requires surgery for correction

    Braun, T., Trost, J., & Pederson, W. (2016). Paediatric Plastic Surgery Procedures. Syndactyly
    Release. 30(4), 162-170. DOI: 10.1055/s-0036-1593478

    E. Acro-osteolysis

    · Slow progressive bone reabsorption


    (osteolysis) of the distal phalanges
    of the feet and hand
    · Can affect the terminal tuft of the
    shaft (most common) or the distal
    phalanx (transverse or band acro-
    osteolysis – second most)
    · Cause and development is often
    unclear

     Often associated with severe digital


    ischemia, digital calcinosis, server sensory
    neuropathy, infection, rheumatic disorders,
    endocrinopathies, genetic disorders, and
    lysosomal storage disorders
     X-ray is best diagnostic tool

    Botou, A., Bangeas, A., Alexiou, I., & Sakkas, L.


    (2017). Acro-osteolysis. Clinical
    Rheumatology, 36(1), 9-14. https://doi-
    org.ezproxy.cqu.edu.au/10.1007/s10067-016-3459-7

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