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Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Pes planus or flat feet in children is usually part of normal feet development, particularly in the newly weight-bearing infant. The longitudinal arch of the foot is flat. Associated changes seen include valgus eversion of the heel and outward turning of the forefoot. Laxity at the knee joint resulting in genu valgum may also be present. The child should be encouraged to walk around the room while these changes are observed. Asking an older child to stand on tiptoe may reveal an underlying normal arch. A degree of ligamentous laxity on examination of the heel is expected and probably responsible for the heel eversion. In such benign cases, parents should be reassured and advised that a normal arch is expected to develop with time. Appropriate footwear, walking barefoot and foot inversion exercises (encouraging the child to pick things with his or her feet) may all be encouraged. The child, however, should be monitored for the development of red flags that include pain, hypermobility or rigidity. This may be due to bony or soft tissue abnormalities leading to ‘tarsal coalition’, a congenitally vertical talus (rocker-bottom feet) or neurological problems such as cerebral palsy.
Facial Clefts
Published in Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan, Problem-Based Obstetric Ultrasound, 2019
Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan
Trisomy 13 (Patau syndrome): Mother's age is likely to be advanced. The nuchal translucency may have been raised at 11–14 weeks. Cell-free DNA might have already been performed in the first trimester. Other indicators of trisomy 13 may be present; there may be CNS abnormalities such as ventriculomegaly or holoprosencephaly. Heart abnormalities are present in over 95% of fetuses. Polydactyly and rocker bottom feet may be seen.
The ankle and foot
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
This rare condition is seen in infants, usually affecting both feet. Superficially it resembles other types of valgus foot, but the deformity is more severe; the medial arch is not only flat, it is the most prominent part of the sole, producing the appearance of a rocker-bottom foot (Figure 21.11). The hindfoot is in equinus and valgus and the talus points almost vertically towards the sole; the forefoot is abducted, pronated and dorsiflexed, with subluxation or dislocation of the talonavicular joint. Passive correction is impossible.
An eye on the future for defeating hydrocephalus, ciliary dyskinesia-related hydrocephalus: review article
Published in British Journal of Neurosurgery, 2022
Amr Ali Hasanain, Mohamed A. R. Soliman, Reem Elwy, Ahmed A. M. Ezzat, Sameh H. Abdel-Bari, Sascha Marx, Alistair Jenkins, Ehab El Refaee, Ahmed Zohdi
Respiratory system pathology was reported in three studies.21,24,26 Situs inversus was reported by another three studies,22,23,25 while a myriad of congenital malformations was reported by other studies including a complex heart malformation,22 micrognathia with ulnar deviation and absent distal interphalangeal crease on fingers 2–4 in addition to rocker bottom feet and trilobed left lung,23 and an unusual face with large ears and an anti-Mongolian slant to the eyes, horizontal nystagmus, and mild bilateral pes cavus.27
Fetal hydrops – a review and a clinical approach to identifying the cause
Published in Expert Opinion on Orphan Drugs, 2020
Esther Dempsey, Tessa Homfray, John M Simpson, Steve Jeffery, Sahar Mansour, Pia Ostergaard
Trisomy 18 (Edward Syndrome) and Trisomy 13 (Patau Syndrome) are also relatively frequently diagnosed in the context of fetal hydrops. Both are multisystem disorders with Edward syndrome characteristically recognized by the ultrasound demonstration of clenched hands and ‘rocker-bottom feet’. Midline defects are prominent in Patau syndrome with holoprosencephaly and cyclopia seen in addition to multisystem abnormalities. Fetal hydrops develops in 14% of fetuses with trisomy 18 and 3% of those with trisomy 13 [102].
Prenatal diagnosis of double trisomy 48, XXX, +18; case report
Published in Journal of Obstetrics and Gynaecology, 2018
Fedi Ercan, Pelin Taşdemir, Aybike Tazegül Pekin, Berkan Sayal, Hüseyin Görkemli, Ali Acar
At 34 + 1 weeks, the foetus was delivered by caesarean, due to preterm premature rupture of membranes; the woman had a previous caesarean delivery. Birth weight was 1550 g (<third percentile). Apgar scores were 5 and 7 at 1 and 5 min, respectively. A female baby was subsequently delivered with clinical manifestations of clenched hands, rocker-bottom feet, micrognathia, prominent occiput, hypotonia and a ventricular septal defect (Figure 2(A,B)). The infant died of cardiopulmonary failure 8 d after birth.