Академический Документы
Профессиональный Документы
Культура Документы
FACULTY OF MEDICINE
HASANUDDIN UNIVERSITY
ACHONDROPLASIA
Fitriani Syair – C 111 10 833
Hendrina Susan Kasale – C 111 12 027
Ananda Dwiyogi Asadul – C 111 12 161
Hadi Tryadi - C 111 12 331
Marina Ariesta – C 111 13 580
MENTOR:
dr. Pierre Alexander/dr. Iswahyudi
SUPERVISOR:
dr. Muh Ihsan Kitta, M.Kes, Sp.OT
August 08,2018
Introduction
Structural abnormality in the bone leads to
disturbances in growth of the trunk or
extremities.
More than 300 bone dysplasias have been
described, most of which are extremely rare
Most of the bone dysplasias result in short
stature
Some of the dysplasias are genetically
inherited, whereas others are not.
Anatomy of epiphysis
The Stages of Long Bone Development
Enchondral Ossification
Appositional
In Proliferative zone,
chondrocytes divide and
stack into columns
In Achondroplasia, there is a mutation in the gene coding for Fibroblast Growth
Factor Receptor 3 (FGFR3)
Diagnosis
Anamnesis
Physical examination
Laboratory examination
Radiographic findings
Anamnesis
Previous disease
Family history
History of development and growth
Pregnancy history
Uterine trauma
Infection while pregnant
Teratogenic events
History during labour
Nutritional status
Previous trauma
Physical Examination
Craniofacial features
are as follows:
-Large calvarial bones in
contrast to the small
cranial base and facial
bones
-True megalencephaly
(large head) with frontal
bossing
-Midface hypoplasia
Physical Examination
Skeletal features are as follows:
Disproportionate short stature: Male average adult
Genu Varum
Physical Examination
Neurologic
findings are as
follows:
-Hypotonia in
infancy and early
childhood
-Delayed motor
milestones
Laboratory Examination
Direct DNA analysis of FGFR3 mutations is
used for prenatal screening in families at risk
(ie, parents who are heterozygous for either
the G1138A or the G1138C mutation).
Radiology Examination
Fetal USG → Early diagnosis, skeletal
anomalies and measure long bones (fetal
femoral length) and evaluate the skull.
Plain X-Ray:
- Os cranium is relatively
enlarged compared to the face
accompanied by frontal
protrusion.
- Foramen magnum shrinks and
irregular funnel-shapped shape.
Plain X-Ray:
- Chest anteroposterior diameter
decreases with anterior rib
shortening.
-Bones of bone from the
hands and feet look short
lumbar kifosis and wide
-Trident-shaped hands are
often found
- its length
decreases,
especially in the
proximal limb
segment
- The fibula
extends and
bends
Radiology Examination
A large cranial vault with relatively short skull base with prominent forehead,
depressed nasal bridge Narrowing of the foramen magnum with cervicomedullary
kinking.
Differential Diagnosis
Hypochondroplasia
Thanatophoric dysplasia
SADDAN Syndrome → Severe Achondroplasia
with Development Delay and Acanthosis
Nigricans
Pseudoachondroplasia
Treatments and Managements
Based on clinical manifestations
Short stature → GH therapy, extended limb
lengthening (complications are frequent)
Kyphosis → bracing support to prevent
persistence of thoracolumbar kyphosis
Hydrocephalus → know the symptomps of
increased ICP → ventriculoperitoneal shunting
Thoracolumbar Spinal Brace
Complications