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Normal and pathological development of the human skeleton before 21 weeks GA

This presentation by Dr. Inger Kjær explores the normal and pathological development of the human skeleton before 21 weeks gestational age (GA). Topics include the sequence and morphology of ossification, developmental courses, and specific anomalies such as Meckel-Grubers syndrome and Turner syndrome. The lecture is based on research conducted at the University of Copenhagen.

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Normal and pathological development of the human skeleton before 21 weeks GA

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  1. Normal and pathologicaldevelopmentof the human skeletonbefore 21 weeks GA Inger Kjær Professor, Dr Odont et Dr Med Faculty of Health Sciences Institute of Odontology University of Copenhagen, Denmark 2015 IPPA Update Course Australia, 22nd-27th November 2015

  2. Spranger JW et al. 1982

  3. Normal development • extremities • body axis, vertebral column • cranium • Questions to ask: • Wheredoesossificationbegin? • Sequence: In whatorder do the bones of • the upper extremitiesossify? • -Morphology: What is the initial appearance • of the osseousprimordia? • -Developmentalcourses: How is the • osseousmorphology changed along the • way?

  4. GA 8 ½ W Normal development • CRL 31 mm, GA 9 W

  5. CRL 30 mm, GA 9 W Normal development • CRL 40 mm, GA 10 W

  6. Normal development • CRL 87 mm, GA 14 W • CRL 55 mm, GA 11½ W

  7. Normal developmentsequence, morphologyand developmentalcourses The hand • GA 16 weeks

  8. Normal development

  9. CRL 31 mm, GA 9 W • Normal development of • extremities • body axis, vertebral column • cranium Lowerextremity

  10. Normal development

  11. Normal development

  12. Normal development

  13. Normal development • Clavicula

  14. GA 19 W Costae and columnavertebralis Normal development • GA 11½ W • GA 12½ W • 94-02 • 1803-88 • HH 01-94

  15. Normal development Pattern of ossification

  16. Os nasale Normal development

  17. Normal development • extremities • body axis, vertebral column • cranium Cranium

  18. Normal development Le Douarin, 1974 Larsen WJ. Human Embryology, 2001

  19. Normal developmentalfields

  20. CRL=67 mm • CRL=119 mm • CRL=151 mm

  21. Basilar part of occipital bone

  22. Pars basilaris os occipitale

  23. Spranger JW et al. 1982

  24. Spontaneousabortions?

  25. Handmalformations • Meckel-Grubers syndrom, • GA 23 W

  26. Holoprosencephaly Cleftlip

  27. Holoprosencephaly face

  28. Holoprosencephalybrain Jean Keeling

  29. Holoprosencephali Holoprosencephalyskeleton

  30. Holoprosencephalycranium

  31. Crouzonsyndrome, 10q26

  32. Body axes in different genotypes (pink:Alwaysmalformed)

  33. Basial part of occipital bone in differentmalformations

  34. Trisomy 21

  35. dfgjjklfgdyttrtyrybbuuuuiuyuuyuuuuuuuuuuuuuuuuuu • dfgjjklfgdyttrtyrybbuuuuiuyuuyuuuuuuuuuuuuuuuuuu

  36. Turner syndrome Turner Syndrome

  37. Turner syndrome

  38. Turner syndromehand

  39. Anencephaly

  40. Kjær et al, 1994

  41. Fetalamniotic band sequence Keeling and Kjær, 1994 • Keeling and Kjær, 1994

  42. Keeling and Kjær, 1994 • Keeling and Kjær, 1994

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