Congenital Clavicular Pseudarthrosis – A Rare Diagnosis
Marta Isabel Pinheiro1*, Cristina Ferreras1, Jorge Coutinho2, Maria Gorett Silva1 and Hercília Guimarães1,3
1Department of Neonatology, Regular Nursery, Centro Hospitalar e Universitário de São João, Portugal
2Paediatric Orthopaedic Unit, Department of Orthopaedics and Traumatology, Centro Hospitalar e Universitário de São João, Portugal
3Faculty of Medicine, University of Porto, Portugal
Submission: November 26, 2019; Published: December 11, 2019
*Corresponding author: Marta Isabel Pinheiro1, Department of Neonatology, Regular Nursery, Centro Hospitalar e Universitário de São João, Portugal
How to cite this article: Marta Isabel Pinheiro, Cristina Ferreras, Jorge Coutinho, Maria Gorett Silva, Hercília Guimarães. Congenital Clavicular Pseudarthrosis – A Rare Diagnosis. Acad J Ped Neonatol. 2019; 8(3): 555795.DOI: 10.19080/AJPN.2019.08.555795
Keywords: Congenital clavicular pseudarthrosis Clavicle congenital anomaly Pseudarthrosis Neonatology
Introduction
Female newborn with an uneventful pre-natal history. Vaginal delivery at 40 weeks and 3370gr (10-50th percentile) of birth weight. On the first day of life, the pediatrician describes a crackling in the middle third of the right clavicle with symmetrical Moro reflex, no palpable swelling or painful region and normal mobility of the upper limbs. Radiological study confirmed the diagnosis of congenital pseudarthrosis of the clavicle, showed an interruption in the medial region of the clavicle with rounded edges and no evidence of bone callus formation (Figure 1). The patient follow-up is in Children`s Orthopaedics outpatient, remains asymptomatic and has no other clinical complications. Congenital clavicular pseudarthrosis is a rare benign anomaly [1], first reported in 1910 [2]. This condition resulting in a failure of coalescence of the two primary ossification centers, during embryogenesis, which produces two portions of the clavicle connected by a fibrous bridge. The exact etiology is unknown. Ninety percent occur on the right side and it’s more prevalent in girls [3]. Bilateral occurrence may be associated with genetic syndromes. Generally, simple radiography is sufficient to confirm the diagnosis [4]. Differential diagnosis, especially in neonates, mainly includes the clavicle fracture due to birth trauma [1]. However, when the clinical findings are contradictory, this condition should be considered, with radiology being an important auxiliary. In most situations, an expectant attitude is adopted. Surgical treatment is recommended when there are functional limitations, progressive pain, onset thoracic outlet syndrome or unacceptable cosmetic deformity [3].
Conflict of interest:
The authors confirm that there are no known conflicts of interest associated with this publication.
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