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Radiology
Caudal Regression Syndrome
Built from Obstetric Imaging
What’s inside
10 sections · 63 slides
Overview
- What this deck covers
The tail end of the embryo
Where the lower spine, gut and urinary tract come from
- The body is built from the head downwards
- One source, many organs
- Why one small error causes many problems
- What caudal regression syndrome means
- How much of the spine can be missing
- The bones at the tail end of the spine
- The many names for one condition
- Where sirenomelia sits
How common, and who is at risk
A rare condition that stops being rare in diabetic pregnancy
- 1.3 : 10,000
- How often it happens
- Blood sugar is the main risk
Why it happens
Genes, chance, sugar and vitamin A handling
- From high sugar to a spine that stops early
- Timing is everything
- More than one cause at a time
- Other factors that have been blamed
- What the genetics actually show
- Currarino syndrome: a named triad
- What animal work points to
What it looks like in the child
Body shape, bladder and bowel, and the anomalies that travel with it
- The body shape you can see
- Nerves, bladder and bowel
- Newborn skeleton with the legs held cross-legged
- Other malformations are the rule, not the exception
- Anomalies reported alongside caudal regression
- Associated Anomalies
- Two named patterns worth recognising
- What decides how the child will do
Seeing it on ultrasound
The classic signs, the timing, and the traps
- The classic ultrasound picture
- Frog-leg position of both lower limbs
- First-trimester clues
- When the diagnosis becomes possible
- Why the scan has to wait
- Findings later in gestation
- Missing bone in the coronal view
- The shield-shaped sacrum
- Fused iliac wings on the transverse view
- The pelvic blades in a normal skeleton
- V-shaped femora and legs that do not move
- Thigh bones fixed in a V
- The sagittal view finds the level
- Where the spine simply stops
- The trap: a spine that seems to taper
- What to do once CRS is suspected
- The scan plan in full
- A three-dimensional view of the fetal spine
Magnetic resonance imaging
A second look when ultrasound cannot see enough
- When MRI is worth adding
- What MRI shows
- “
Differential diagnosis
What else produces this picture on the screen
- What else can look like this
- Caudal regression versus sirenomelia
- A single fused lower limb
Counselling and care
Nothing to fix before birth, a great deal to plan
- Before birth: prevention is the only lever
- After the diagnosis is made
- After birth: a team job
- The four treatment goals
- What the referring physician needs to know
Key points
The eight things to carry away
- Key points
- Key points
- Suggested reading
- References
- References (continued)
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition