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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 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
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?
GA 8 ½ W Normal development • CRL 31 mm, GA 9 W
CRL 30 mm, GA 9 W Normal development • CRL 40 mm, GA 10 W
Normal development • CRL 87 mm, GA 14 W • CRL 55 mm, GA 11½ W
Normal developmentsequence, morphologyand developmentalcourses The hand • GA 16 weeks
CRL 31 mm, GA 9 W • Normal development of • extremities • body axis, vertebral column • cranium Lowerextremity
Normal development • Clavicula
GA 19 W Costae and columnavertebralis Normal development • GA 11½ W • GA 12½ W • 94-02 • 1803-88 • HH 01-94
Normal development Pattern of ossification
Os nasale Normal development
Normal development • extremities • body axis, vertebral column • cranium Cranium
Normal development Le Douarin, 1974 Larsen WJ. Human Embryology, 2001
CRL=67 mm • CRL=119 mm • CRL=151 mm
Handmalformations • Meckel-Grubers syndrom, • GA 23 W
Holoprosencephaly Cleftlip
Holoprosencephalybrain Jean Keeling
Holoprosencephali Holoprosencephalyskeleton
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Turner syndrome Turner Syndrome
Fetalamniotic band sequence Keeling and Kjær, 1994 • Keeling and Kjær, 1994
Keeling and Kjær, 1994 • Keeling and Kjær, 1994