What challenges can be expected when arthrogryposis is indicated on the adoptive child's medical record?
Arthrogryposis refers to a symptom complex characterized by multiple joint contractures present at birth. This is a description of what we see when the child is born. It is usually caused by decreased fetal movement of whatever etiology.
This is merely a description of a symptom however because there are approximately 150 different syndromes occurring with multiple congenital contractures that are characterized as arthrogryposis.
The major syndrome (amyoplasia) accounts for approximately 50% of children who have multiple congenital contractures. The cause of this syndrome is unknown but it can affect all of the muscles in the body and can even lead to respiratory failure.
The classic presentation of arthrogryposis is contractures of all four extremities but it is possible to carry this diagnosis and have only contractures of one extremity but this is rare.
X-rays need to be taken to rule out underlying spinal deformities and hip dysplasia
To understand how difficult and complex the diagnosis can be, imagine that the syndrome can start anywhere from the brain to spinal cord to peripheral nerves to the muscles. Therefore they need a thorough evaluation. . Laboratories might be able to rule out congenital muscular dystrophies and chromosome abnormalities these can be done at birth to help elucidate the etiology.
Every child with these syndromes should have a complete musculoskeletal evaluation and genetics evaluation.
Most of the children who have this diagnosis at birth survive to adulthood and need different medical interventions depending on their diagnosis.
Surgery is needed usually in all of these children and extensive splinting and physical therapy to help improve and get some function.
These children can be very intelligent (as long as the arthrogryposis is not secondary to a syndrome) so that they can make significant adaptations to their disability and lead productive lives.
The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.
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© James Reilly, M.D.
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