advanced usg lounge fetal feet
DESCRIPTION
FETAL FEET IMAGINGTRANSCRIPT
Dr Arun Gupta Director imaging
Dr Rakhee gupta Dr Vinayak Mittal Dr Ritesh Mahajan
ADVANCED USG LOUNGE
FETAL ANOMALY SERIES FETAL FEET
ADVANCED USG LOUNGE
SECOND GRAVIDA WITH POG of 15WKS 6DAYS
? LMP (Lactational Amenorrhoea).Uneventful first pregnancy .Present Sonogram findings are s/o Bilateral
club foot ( Talipes varus). Possibly isolated abnormality .
Rest of the scan per se was normal .
NORMAL FETAL FEET
THREE –D RENDERED IMAGES
squared angle between
Long axis of foot and leg.
TALIPES VARUS
INVERTED PLANTAR FLEXED MEDIALLY DEVIATED FEET .
( BILATEEAL CLUB
FOOT WITH ASSOCIATED
HINDFOOT VARUS ) .
Inward deviation of both the fetal Feet is appreciated . There is associated hindfoot varus .
Rounding of the angle between feet and leg is appreciated .
Long axis of the metatarsals are visualized in the same plane as leg .
FOLLOWING SPECTRUM OF
ABNORMALITIES CAN BE ASSOCIATED WITH
CLASSIC TALIPES
•Hind foot equinus ( plantar flexion)
•Hind foor varus ( inward rotation)
•Forefoot adduction
•Forefoot cavus
INWARD ANGULATION ROUNDING OF ANGLE BETWEEN LEG AND FEETNO ATROPHY OF CALF MUSCLES APPRECIATED
( CAN BE SEEN IN ASSOCIATED MUSCULAR DYSTROPHIES)
GREY SCALE 2D IMAGES OF THE TALIPES VARUS
LONG AXIS OF METATARSALS IS APPRECIATED IN SAME PLANE AS
ALONG THE LONG AXIS OF
THE LEG
NORMAL SPINENORMAL FACE FETAL BIOMETRY ASSESSED.
CLASSICAL TALIPES
Spectrum of abnormalities associated with variable degree of contracture at ankle region /along with tendon abnormalities .
May be isolated or associated with neurological defects ( spina bifida) , neuromuscular ( FADS) ,environmental factors( oligohydramnios, uterine abnormalities , Early rupture of the membranes, Fetal crowding due to multiple gestation).
Two types : Talipes varus Talipes equinus
TALIPES VARUS ( CLUB FOOT)
Occurs in 0.1 to 0.2% of population.Recurrence rate after birth of first child with club foot is 2%
to 3% and if one parent is affected the recurrence risk is 3% to 4% .
Majority are isolated deformations. Early amniocentesis is associated with increased risk of club
foot . Normal foot can also achieve extreme dorsiflexion / plantar
flexion and caution should be exercised while making isolated diagnosis of club foot especially in late gestation.
Congenital talipes equinovarus has spectrum ranging from : Postural talipes / Non rigid deformity Severe rigid deformity .
REFERENCE
DIAGNOSTICULTRASOUNDFOURTH EDITIONCarol M. Rumack, MD, FACRJ. William Charboneau, MD, FACRDeborah Levine, MD, FACR
Ultrasound of CongenitalFetal AnomaliesDifferential Diagnosis and Prognostic IndicatorsDario Paladini MDHead, Fetal Cardiology UnitDepartment of Obstetrics and GynecologyUniversity Federico II of NaplesNaplesItalyPaolo Volpe MDHead, Fetal Medicine UnitDepartment of Obstetrics and GynecologyHospital Di VenereBari