CHIR12007

Clinical Assessment and Diagnosis

Portfolio Exercises Week 8

Self-directed learning:

The following conditions are congenital disorders or alterations in development that may
have clinical consequences and may mimic other conditions.
Investigate the following conditions. Include a description of the condition, relevant clinical
history, any associated clinical findings, associated clinical or systemic features and any
additional information you feel may be important as a chiropractor. (also incl reference(s))

A. Congenital Radioulnar Synostosis

- Rare abnormal bony or soft tissue connection between the radius and the ulna of
the forearm.
- Develops in the womb when the bones do not separate as they usually would
between 5 and 8 weeks of gestation
- 1 in 5 cases due to a family history
- Cano occur as part of underlying syndrome: other skeletal abnormalities (33%),
problems with heart, kidneys, nervous system or GI system, genetic syndromes,
alchohol syndrome
- Boys and girls are equally effected, 60% have it in both arms
- Sign and symptoms include limited ROM in pronation and supination, abnormal
carry angle or shortened forearm
- Not usually painful for baby but if left untreated can cause pain in teens
- Diagnosis through x-ray or CT scan
http://www.childrenshospital.org/conditions-and-treatments/conditions/r/radioulnar-
synostosis/symptoms-and-causes

B. Ulna Minus Variant

- Condition where the ulnar is abnormally shortened in comparison to the radius
- Association between ulna minus variant and Kienbock disease
- Lower prevalence in males than females
- Prevalence increases with age
https://www.orthobullets.com/hand/6046/ulnar-variance

C. Madelung’s Deformity
- More common in females
- Premature closure or defective development of the ulnar third of the distal
epiphysis of the radius. Results in a radial shaft that is bowed with increases
interosseous space and dorsal subluxation of the distal radioulnar joint
- Bilateral in 50-66% of patients
- Often doesn’t manifest until 10-14 yrs
- May be acquired through trauma to growth plate
- Decreased grip strength
 - Pain in the wrist

D. Syndactyly
- Fingers or toes are webbed or joined at birth
- Common – 1 in 2500 babies
- Congenital
- Caucasians more likely and boys more likely
- Bilateral 50% of time
- Different types and degrees of complexity
- Occurs due to failure of the division of the fingers in weeks 6-7 of gestation

http://www.childrenshospital.org/conditions-and-treatments/conditions/s/syndactyly

E. Acro-osteolysis
- Reabsorption of the distal phalanx

Not a lot of information on this one