Inger Kjær Professor, Dr Odont et Dr Med Faculty of Health Sciences Institute of Odontology...
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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
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Spranger JW et al. 1982
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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?
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GA 8 ½ W CRL 31 mm, GA 9 WNormal development Normal development
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CRL 30 mm, GA 9 W
CRL 40 mm, GA 10 W
Normal development Normal development
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CRL 55 mm, GA 11½ W CRL 87 mm, GA 14 W
Normal development Normal development
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Normal development sequence, morphology and developmental courses
The hand
GA 16 weeks
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Normal development Normal development
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CRL 31 mm, GA 9 WNormal development of
•extremities•body axis, vertebral column•cranium
Lower extremity
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Normal development Normal development
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Normal development Normal development
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Normal development Normal development
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Normal developmentNormal development
Clavicula
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HH 01-941803-8894-02
GA 11½ WGA 12½ W
GA 19 WCostae and columna vertebralisCostae and columna vertebralisNormal developmentNormal development
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Pattern of ossificationPattern of ossification
Normal development Normal development
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Os nasaleNormal development Normal development
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Normal development
•extremities•body axis, vertebral column•cranium
Cranium
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Le Douarin, 1974
Larsen WJ. Human Embryology, 2001
Normal development Normal development
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Normal developmental fields Normal developmental fields
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CRL=67 mm CRL=119 mm CRL=151 mm
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Basilar part of occipital bone
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Pars basilaris os occipitale
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Spranger JW et al. 1982
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Spontaneous abortions?
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Meckel-Grubers syndrom, GA 23 W
Hand malformations
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Holoprosencephaly Cleft lip
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Holoprosencephaly face
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Holoprosencephaly brain
Jean Keeling
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HoloprosencephaliHoloprosencephaly skeleton
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Holoprosencephaly cranium
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Crouzon syndrome, 10q26
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Body axes in different genotypes (pink:Always malformed)
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Basial part of occipital bone in different malformations
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Trisomy 21
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Turner syndrome
Turner Syndrome
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Turner syndrome
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Turner syndrome hand
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Anencephaly
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Kjær et al, 1994
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Keeling and Kjær, 1994Keeling and Kjær, 1994
Fetal amniotic band sequence
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Keeling and Kjær, 1994Keeling and Kjær, 1994
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Thanks to fetal pathologists:Jean Keeling, UKBirgit Fischer Hansen, DK
Powerpoint: Eva Marie Reinwald