Evidence map›Paper›PMID 29797037›Full record

ArticlePediatric radiology2018

Constant inhibition in congenital lower extremity shortening: does it begin in utero?

Andy Tsai, Tal Laor, Judy A Estroff, James R Kasser

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Article in Pediatric radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

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1citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Andy TsaiDepartment of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA. andy.tsai@childrens.harvard.edu.ORCID 0000-0002-0089-6463
Tal LaorDepartment of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.
Judy A EstroffDepartment of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.
James R KasserAdvanced Fetal Care Center, Boston Children's Hospital, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimb-length discrepancy (LLD) in children with congenital lower extremity shortening is constant in proportion from birth to skeletal maturity (known as constant inhibition), but its developmental pattern in utero is unknown. The popular prenatal multiplier method to predict LLD at birth assumes constant inhibition in utero to be true. Verifying the in utero developmental pattern of LLD, and thus confirming the validity of the prenatal multiplier method, is crucial for meaningful prenatal parental counseling.

objectiveTo elucidate the in utero developmental pattern of LLD in fetuses with congenital lower extremity shortening. MATERIALS AND

methodsClinical indications for 3,605 lower extremity radiographs performed on infants (<1 year old) at a large tertiary hospital over a 17-year period were reviewed. Inclusion criteria were (1) diagnosis of congenital lower extremity shortening, (2) bilateral lower limb postnatal radiographs documenting LLD and (3) fetal ultrasound (US) documenting LLD. Available measurements of femoral, tibial and fibular lengths on fetal US and postnatal radiographs were collected. Prenatal and postnatal length ratios of shorter-to-longer bones were calculated and compared.

resultsEighteen infants met inclusion criteria. Diagnoses were proximal focal femoral deficiency=4, congenital short femur=2, tibial hemimelia=3, posteromedial tibial bowing=6 and fibular hemimelia=3. The correlations between postnatal and prenatal length ratios were high for the femur, tibia and fibula (R>0.98, P<0.0001). The relative differences in the postnatal and prenatal length ratios of these bones were small (|average|<0.026, standard deviation <0.068).

conclusionOur data indicate that the postnatal and prenatal length ratios were equivalent, supporting the constant inhibition pattern of LLD in utero, thus validating the prenatal multiplier method for predicting LLD.

Indexed as

Ultrasonography, PrenatalFemaleHumansInfantInfant, NewbornLeg Length InequalityMalePregnancyRetrospective StudiesX-RaysConstant inhibitionFetusInfantsLimb-length discrepancyLower extremityPrenatal multiplier methodRadiographyUltrasound

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.