| Findings: Pelvis X-ray (fig.1,2):
1. Coxa vara of both hips.
2. Delayed ossification of pubic bones.
3. Wide symphysis pubis.
4. Narrow bilateral iliac wings. Chest X-ray (fig.3):
1. Hypoplasia of bilateral clavicles with symmetric absence of
bilateral distal clavicles.
2. Somewhat bell-shaped thorcic cavity. CT scan of facial bones with multiplanar reconstruction, thick
curved multiplanar reconstruction (cMPR), maximum-intensity
projection (MIP), 3D volume rendering (VR), and without
intravenous contrast (fig.4-26) : 1. Multiple mosaic accessory bone plates along sagittal and
bilateral lambdoid sutures with somewhat symmetric distribution,
in favor of multiple wormian (sutural) bones, possibly
associated with some kinds of skeletal abnormality (fig.4).
(Differential diagnosis: osteogenesis imperfecta, cleidocranial
dysplasia, hypothyroidism, etc).
2. Persistent synchondrosis in skull (fig.4), facial bones, and
cervical vertebrae (fig.5-9) with paired frontal bones due to
obvious metopic suture from closed anterior fontanel to frontonasal
suture (fig.4).
3. Small size of bilateral maxillary sinuses and undevelopment
of frontal and sphenoid sinuses (fig.10), suggesting some degree
facial bone hypoplasia.
4. Complete nondevelopment of bilateral mastoid air cells (fig.9).
5. Delay detachment of right lower deciduous canine and fist and
second deciduous premolars with uneruption of corresponding
permanent teeth (fig.12).
6. Delay detachment of left lower deciduous canine and fist
deciduous premolar with uneruption of corresponding permanent
teeth (fig.12).
7. Supernumerary teeth within maxilla with irregular arrangement
(fig.13-24).
8. Decreased ossification of hyoid (fig.5-6,13,26);
Steep vertical clivus (fig.10);
High anterior arched hard palate (fig.25-26). Impression:
1. Multiple abnormalities in skull, facial bones, and vertebrae.
2. All of the findings could be compatible with cleidocranial
dysplasia. |
070828 CLEIDOCRANIAL DYSPLASIA
