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Spot The Diagnosis

Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Mar 5, 2013.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    What is your medical diagnosis for this case ?

    Spot The Diagnosis .jpg
     

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  2. neo_star

    neo_star Moderator

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    left hand, ring finger missing - Oligodactyly

    and the index and middle finger are short in comparison to the little finger - Brachydactyly


    Diagnosis - Oligodactyly + Brachydactyly


    I guess it cud b sec. to an interruption in blood supply ( many such examples of in utero interruption of vascular supply exist - ex. when blood supply to a segment of intestine is interrupted - u have intestinal atresia )


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    Some titbits from Wiki

    Oligodactyly is sometimes a sign or symptom of several syndromes including Poland syndrome and Weyer Ulnar Ray Syndrome.

    Ectrodactyly involves the deficiency or absence of one or more central digits of the hand or foot and is also known as split hand/split foot malformation (SHFM). The hands and feet of people with ectrodactyly are often described as "claw-like" and may include only the thumb and one finger (usually either the little finger, ring finger, or a syndactyly of the two) with similar abnormalities of the feet.

    The Doma, also Vadoma or Wadoma (singular Mudoma), are a tribe living in the north of Zimbabwe, especially in the Urungwe and Sipolilo districts on the Zambezi river valley. A substantial minority of this tribe has a condition known as ectrodactyly in which the middle three toes are absent and the two outer ones are turned in, resulting in the tribe being known as the "two toed" or "ostrich footed" tribe.

    ref - wiki
     

    Last edited: Mar 5, 2013
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  3. victor29

    victor29 Well-Known Member

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  4. neo_star

    neo_star Moderator

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    Second possible etiology is a constriction ring syndrome aka Adam complex aka Amniotic Band syndrome, since the index and middle fingers are slightly swollen ( segments proximal to the ring show soft tissue swelling and those distal can get amputated )...but that still doesn't explain the seemingly absent ring ray. So, i guess there r multiple etiologies in play here
    1) brachydactyly can be explained by an amniotic band
    2) oligodactyly must have another etiology, esp. if the entire ray is missing i.e metarpals and phalanges(need an x ray ). If only the phallanges were missing ( only an x ray can say ), then it can be explained by amniotic band.

    and if this child had syndactyly, then i must say that the surgeons have done a good job in giving this child a cosmetically and functionally ( i am sure ) better hand.

    This looks like a good case...pls. guys keep ur opinions
    (-:
     

    Last edited: Mar 5, 2013
  5. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    Oligodactyly cum brachydactyly. I agree with Neo.
     

  6. neo_star

    neo_star Moderator

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    Nice article on limb reduction defects

    The finding of a limb reduction defect in an otherwise healthy baby can be very disappointing for expectant parents. The complexities of coping with this kind of disability seem daunting at first and are often associated with feelings of guilt and anger:

    Is this due to something I did?,
    medicines I have taken?
    Is some environmental
    hazard to blame?


    Read entire article here
     

  7. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer : Oligodactyly
     

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