Arthrogryposis Multiplex Congenita (AMC) Flashcards
AMC is NON-Progressive
NON-progressive****
What is AMC?
NON-progressive NMSK syndrome present @ birth
Characterized by severe jt contractures, mm weakness, fibrosis
Artwork 1700’s, addressed 1950’s
AMC Defined
Defined by presence of contractures in 2 or more body areas***
AMC Incidence/Etiology
- Etiology unclear
- Insult occurs First Trimester
- MMs form normally→ replaced by fibrous fatty tissue during fetal dev.
-
Basic mechanism→ DECd fetal mvmt in-utero
- 6 Primary reasons for lack of mvmt***
6 Causes of Decd Fetal Mvmt:
- Maternal illness
- Fetal Crowding→ twins, etc.
- Neuro defs
- Vascular compromise
- Connective tissue/skeletal defects
- MM defects
Dx of AMC
- No definitive prenatal test or preventative measures*
- Blood work, CVS, amniocentesis typ inconclusive
- High-lvl US is MD suspects
- Post-natally→ mm biopsy, blood work, clinical findings can R/O other dx
Dx of AMC
Dr. Polumbo said this about In-Utero
KNOW IT!!!
Lt-mod exercise
Deep Breathing
NO Caffeine
AMC Clinical Manifestations
- Great variation, BUT gen. include:
- Severe jt contractures, lack of mm dev. (Amyoplasia***)
- Typ impacted body parts: in order MOST→LEAST
- Foot (78-95%)
- Hip (60-82%)
- Wrist (43-81%)
- Knee
- Elbow
- Shoulder
- 2 Common Variations***
Two Main Types AMC:
Jackknifed vs. FrogLike
2 Main Types of AMC:
JACKKNIFED
*bold= also found in Froglike
- Flexed/dislocated hips
- Extd knees
- Clubfeet* (equinovarus)
- IR shoulders*
- Flexed elbows
- Flexed and ulnarly deviated wrists*
2 Main Types AMC:
FROGLIKE
bold*= also found in JACKKNIFED
- ABD and ER hips
- Flexed knees
- Clubfeet* (equinovarus)
- IR shoulders*
- Extd Elbows
- Flexed and Ulnarly deviated wrists*
JACKKNIFED vs. FROGLIKE
Only Differences
-
Jackknifed:
- Flexed/disloc’d hips
- Extd knees
- Flexed elbows
-
FrogLike:
- ABD/ER hips
- Flexed knees
- Extd elbows
JACKKNIFE VS FROGLIKE
Similarities:
Clubfeet* (equinovarus)
IR Shoulders*
Flexed and Ulnarly deviated wrists*
Medical Mgmt AMC:
Well-timed Sx mgmt
-
Well-timed Sx mgmt→ Limbs and Spine*
- Foot sx gen. prolonged until child pulling sit→stand OR interested in standing
-
*Hip Dislocations:
- U/L→ typ CORRECT
- B/L→ typ DELAYED
Hip Dislocations and AMC and fix or leave alone
- U/L→ typ CORRECT: bc prevent pelvic obliquity
- B/L→ typ DELAY: bc if no pain or asymm→ better to keep moving and avoid sx