Streeter Dysplasia Workup

  • Author: Twee T Do, MD; Chief Editor: Dennis P Grogan, MD   more...
 
Updated: Feb 7, 2012
 

Laboratory Studies

  • Because amniotic band syndrome is an extrinsic yet spontaneous phenomenon, no good laboratory tests exist to detect its presence. Levels of α -fetoprotein have been shown to be elevated with normal acetylcholinesterase activity, but this elevation may be due to the anencephaly (with positive acetylcholinesterase isoenzymes) or fetal demise (negative acetylcholinesterase isoenzymes).
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Imaging Studies

  • Serial ultrasounds can show the gross lack of formation, such as anencephaly or intrauterine amputations, but ultrasound studies of monozygotic twins have been disappointing.[18] One study reported ultrasonic evidence of ABS in both twins, but only one twin had clinical manifestations (and those were severe). With the advancement of ultrasound technology and the availability of 3-D and 4-D ultrasound, the defect can now be characterized down to the level of how the nerves and muscles are affected distally.[19, 20, 21] Prenatal diagnosis of atypical facial clefting should alert physicians to the possibility of ABS and other anomalies.[22, 23] This may help prenatal counseling and family preparation.
  • MRI could be considered preoperatively on limbs with deep bands to evaluate the neurovascular status.[24]
  • Magnetic resonance angiography of limbs affected by ABS may reveal vessel deficiencies and variable anatomy that could affect the surgical outcome.
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Diagnostic Procedures

  • Amniocentesis has been associated with membrane rupture after needle placement. Therefore, it has no significant place in the diagnosis or treatment of this syndrome.
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Contributor Information and Disclosures
Author

Twee T Do, MD  Clinical Faculty, Rocky Vista University College of Osteopathic Medicine; Consulting Surgeon, Pueblo Bone and Joint Clinic

Twee T Do, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, Colorado Medical Society, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Charles T Mehlman, DO, MPH  Professor of Pediatrics and Pediatric Orthopedic Surgery, Division of Pediatric Orthopedic Surgery, Director, Musculoskeletal Outcomes Research, Cincinnati Children's Hospital Medical Center

Charles T Mehlman, DO, MPH is a member of the following medical societies: American Academy of Pediatrics, American Fracture Association, American Medical Association, American Orthopaedic Foot and Ankle Society, American Osteopathic Association, Arthroscopy Association of North America, North American Spine Society, Ohio State Medical Association, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

George H Thompson, MD  Director of Pediatric Orthopedic Surgery, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, and MetroHealth Medical Center; Professor of Orthopedic Surgery and Pediatrics, Case Western Reserve University School of Medicine

George H Thompson, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society

Disclosure: OrthoPediatrics None Consulting; Journal of Pediatric Orthopaedics Salary Management position; SpineForm None Consulting; SICOT None Board membership

Dinesh Patel, MD, FACS  Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital

Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dennis P Grogan, MD  Clinical Professor, Department of Orthopedic Surgery, University of South Florida College of Medicine; Chief of Staff, Department of Orthopedic Surgery, Shriners Hospital for Children of Tampa

Dennis P Grogan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Eastern Orthopaedic Association, Irish American Orthopaedic Society, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society

Disclosure: Nothing to disclose.

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Image shows the lower limb of a young child born with moderate bands that extend deep to the fascia but do not compromise the neurovascular system.
 
 
 
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