Case of the Week #580
Shukran Diagnostics Private Limited
27-year-old primigravida presented at 13 weeks, 2 days gestation for a routine Nuchal translucency scan. There was no history of consanguineous marriage or comorbidities.
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Answer
We present a case of Spina Bifida with Lumbosacral meningomyelocele and bilateral talipes equinovarus deformity.
Ultrasound revealed the following findings:
- Sagittal image of the spine shows a small sac with neural elements. The sac approximately measures 1.1 x 0.6 x 0.8 cm (Image 1, Video 1). Axial image of the spine shows divergence of the posterior arches at the lumbosacral level (Image 2, Video 2).
- Cisterna magna could not be visualized and fluid is not seen. There is tight compression of the cerebellum over the occipital bone and the cerebellum is wrapped around the brainstem. Ventricles appear pointed. There is the Lemon sign and Banana sign (Image 3).
- Intracranial translucency is absent. The occipital bone, fourth ventricle, anterior and posterior brain stem demarcation forming four lines is absent. (Image 4).
- The lower extremities are persistently flexed at the knee joint and crossed at the ankles with no motion (Image 5).
- Corresponding 3D images showing and confirming the findings seen in 2D imaging (Image 6-8).
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Javier Cortejoso Spain Physician
belen garrido Spain Physician
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Mayank Chowdhury India Physician
Michaela Apostolou Germany Physician
selçuk pervaz United States Physician
Oskar Sylwestrzak Poland Physician
Vladimir Lemaire United States Physician
Boujemaa Oueslati Tunisia Physician
CHARLES SARGOUNAME India Physician
Aysegul Ozel Turkey Physician
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Emiliano Ciari Argentina Physician
Olivia Ionescu United Kingdom Physician
Shari Morgan United States Sonographer
Annette Reuss Germany Physician
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Dimitrios Spiliopoulos Greece Physician
ALBANA CEREKJA Italy Physician
SAMUEL GELVEZ TELLEZ Colombia Physician
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Kathrine Montagne United States Sonographer
Daniil Gagaev Russian Federation Physician
Dr Monika Sharma India Physician
Laura Luse Latvia Physician
Mequanint Melesse Bicha Ethiopia Physician
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Celina Augusta Zanin Poletto Brazil Physician
Usha A India Sonologist and general physician
Cassandra Kaplan United States Insurance Agent
Shinu Abdul Rasheed India Physician
Mary Jones United States Sonographer