Fracture In Utero

Fracture In Utero

The detection of rib or long bone fractures in association with severe micromelia suggests a diagnosis of osteogenesis imperfecta. Fractures may be subtle or may lead to angulation.

Fig 1, Fig2, Fig 3

The major differential diagnoses for fractures in utero are as follows:

• Osteogenesis imperfecta type II (most common)
• Hypophosphatasia (rare)
• Campomelic dysplasia (not a true fracture but bowing).

Fig 1:  Fracture in utero  Longitudinal scan of upper extremity: poorly ossified and fracture in osteogenesis imperfecta type IIA

Fig 2:  Callus formation of long bone  Longitudinal scan of humerus and femur: irregularity due to callus (arrowhead) in osteogenesis imperfecta type IIA

Fig 3:  Rib fractures  Multiple rib fractures with poor ossification in the fetus with osteogenesis imperfecta type IIA