Congenital pelvic skeletal anomalies: Clinical and radiographic evaluation of newborns with gastrointestinal malformation

Early Hum Dev. 2020 Feb:141:104945. doi: 10.1016/j.earlhumdev.2019.104945. Epub 2019 Dec 31.

Abstract

Background: Congenital pelvic skeletal anomalies (CPSA) may appear as isolated defects or in association with other anomalies like congenital malformations of the digestive system (CMDS). Minor CPSA in non-syndromic patients are often overlooked. We aimed to assess the frequency of CPSA in newborns with CMDS to review the diagnostic approaches.

Study design: A retrospective review of medical records of 201 newborns who underwent X-rays for different neonatal indications was conducted. In 122 patients CMDS were diagnosed and classified according to the ICD-10 classification; 79 non-CMDS patients acted as controls. Pelvic skeletal segments were examined by X-rays.

Results: Patients with CMDS, showed a higher risk of CPSA (Odds ratio 2.89; 95% CI 1.34 6.23) and other associated malformations in comparison to non-CMDS patients. Newborns with malformations of the large intestine have the highest risk of adjacent CPSA (48%), as it is a developmental defect originating from the same somite. In addition to skeletal agenesis/hypoplasia, we reported dysmorphic and bifid vertebras, trident ileum, and elongated neural arches.

Conclusions: The high incidence of CPSA in CMDS suggests performing a routine radiographic pelvic evaluation in cases of CMDS in order to identify complex phenotypes that could originate from the same developmental field.

Keywords: Congenital abnormalities; International classification of diseases; Musculoskeletal system; Pelvic bones; Radiography; VACTERL association.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Digestive System Abnormalities / diagnostic imaging
  • Digestive System Abnormalities / epidemiology*
  • Digestive System Abnormalities / pathology
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnostic imaging
  • Infant, Newborn, Diseases / epidemiology*
  • Infant, Newborn, Diseases / pathology
  • Male
  • Musculoskeletal Abnormalities / diagnostic imaging
  • Musculoskeletal Abnormalities / epidemiology*
  • Musculoskeletal Abnormalities / pathology
  • Pelvis / abnormalities*
  • Pelvis / diagnostic imaging
  • Radiography