Arthrogryposis congenita (birth defect, joints contracted)

Master of Alkmaar
1490–1510, Alkmaar, Netherlands

♦ Feed the hungry ♦

A woman stands in the doorway of her home with a basket of bread that her husband distributes to the poor and crippled. Christ stands among the hungry.
In the background is a beggar with a lute.
Part of a series of seven paintings depicting the seven works of mercy.

♦ Diagnosis
Main symptoms: Deformed foot; severe clubfoot, paralyzed, unusable lower legs.
Secondary symptoms: Edema on the legs, crutches.
Clinical diagnosis: Arthrogryposis

♦ Definition: arthrogryposis
Arthrogryposis multiplex congenita is the term used for a heterogeneous group of congenital disorders characterized by extreme stiffness and contractures of the joints surrounded by underdeveloped muscles.

♦ Discussion
Arthrogryposis is a very rare congenital disorder.
The deformities are already present at birth and neither improve nor worsen thereafter. These children are generally not mentally impaired and in many cases the condition is limited to the limbs: the joints of the legs in 40% of cases, those of the arms in 10%, while in half of the cases both the upper and lower limbs are affected.
If the child survives its first year, life expectancy is generally quite high.

Research has shown that anything that prevents normal movement of the joint before birth can result in joint contractures. The joint itself may be perfectly normal.
However, a joint that is not used for a certain period of time tends to produce extra connective tissue that locks the joint in its current position.
Lack of movement of a joint also means that the tendons connected to the joint are not stretched to their normal length. Shortened tendons in turn hinder normal joint movement.

For most types of arthrogryposis, physical therapy has proven to be very effective in improving a whole range of movements in the affected joints.
Surgery can treat congenital malformations, which often accompany arthrogryposis.

Source: Jan Dequeker
The artist and the doctor look at paintings

Source: Jan Dequeker
The artist and the doctor look at paintings

Photo's
Wikipedia

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