Hemihypertrophy and Hemiatrophy

Question 1

Hemi-hypertrophy

Answer 1

1. Wilm’s tumor
2. Russel Silver Syn
3. Beckwith Wiederman Syn
4. Klippel Trenaunay Syn
5. NF type 1
6. Cushing Syndrome
7. Linear scleroderma
8. If one limb only: Local inflammation, AV malformation, Lymphodema, Tumor (e.g. Neurofibroma)
9. Idiopathic

Question 2

Hemi- atrophy

Answer 2

1. Cerebral Palsy
2. Incontinentia Pigmenti
3. Local cause- reduced vascular supply
4. Idiopathic

Question 3

Steps in Examination of Hemi-hypertrophy / Hemi-atrophy

Answer 3

Child in chair

1. Stand up (if failed then do neuro exam / examine spine/ Abdo)
2. Pair up LL —–> Note any Knock knee, bowleg, asymmetry
3. Walk —–> Note any abnormal gait
4. All Normal —-> look for skin rash

Child in bed:
1. Ask to raise LL against gravity
If OK —-> look for: skin rash / Asymmetry of LL / Joint abnormality / Gait
if fail —-> do neuro exam