inger kjær professor, dr odont et dr med faculty of health sciences institute of odontology...
TRANSCRIPT
Inger KjærProfessor, Dr Odont et Dr MedFaculty of Health SciencesInstitute of OdontologyUniversity of Copenhagen, Denmark
Normal and pathological development
of the human skeleton
before 21 weeks GA
2015 IPPA Update CourseAustralia, 22nd-27th November 2015
Spranger JW et al. 1982
Normal development Normal development
•extremities•body axis, vertebral column•cranium
Questions to ask:
-Where does ossification begin?-Sequence: In what order do the bones of the upper extremities ossify?-Morphology: What is the initial appearance of the osseous primordia?-Developmental courses: How is the osseous morphology changed along the way?
GA 8 ½ W CRL 31 mm, GA 9 WNormal development Normal development
CRL 30 mm, GA 9 W
CRL 40 mm, GA 10 W
Normal development Normal development
CRL 55 mm, GA 11½ W CRL 87 mm, GA 14 W
Normal development Normal development
Normal development sequence, morphology and developmental courses
The hand
GA 16 weeks
Normal development Normal development
CRL 31 mm, GA 9 WNormal development of
•extremities•body axis, vertebral column•cranium
Lower extremity
Normal development Normal development
Normal development Normal development
Normal development Normal development
Normal developmentNormal development
Clavicula
HH 01-941803-8894-02
GA 11½ WGA 12½ W
GA 19 WCostae and columna vertebralisCostae and columna vertebralisNormal developmentNormal development
Pattern of ossificationPattern of ossification
Normal development Normal development
Os nasaleNormal development Normal development
Normal development
•extremities•body axis, vertebral column•cranium
Cranium
Le Douarin, 1974
Larsen WJ. Human Embryology, 2001
Normal development Normal development
Normal developmental fields Normal developmental fields
CRL=67 mm CRL=119 mm CRL=151 mm
Basilar part of occipital bone
Pars basilaris os occipitale
Spranger JW et al. 1982
Spontaneous abortions?
Meckel-Grubers syndrom, GA 23 W
Hand malformations
Holoprosencephaly Cleft lip
Holoprosencephaly face
Holoprosencephaly brain
Jean Keeling
HoloprosencephaliHoloprosencephaly skeleton
Holoprosencephaly cranium
Crouzon syndrome, 10q26
Body axes in different genotypes (pink:Always malformed)
Basial part of occipital bone in different malformations
Trisomy 21
dfgjjklfgdyttrtyrybbuuuuiuyuuyuuuuuuuuuuuuuuuuuu
dfgjjklfgdyttrtyrybbuuuuiuyuuyuuuuuuuuuuuuuuuuuu
Turner syndrome
Turner Syndrome
Turner syndrome
Turner syndrome hand
Anencephaly
Kjær et al, 1994
Keeling and Kjær, 1994Keeling and Kjær, 1994
Fetal amniotic band sequence
Keeling and Kjær, 1994Keeling and Kjær, 1994
Thanks to fetal pathologists:Jean Keeling, UKBirgit Fischer Hansen, DK
Powerpoint: Eva Marie Reinwald