Sy Hemihypotrophy

[1234nale]

Did anyone of you have some knowledge of sy. hemihypotrophy?
I have 6 year old childe patient who is 4-th childe from one pregnancy, with this diagnose. To be clear there is no paresis, no decrease of ROM, just decrease in longitude and velocity both arm and leg of the same side.
There is little articles about this issue and in no one is mentioned kinesytherapy treatment.
Any info will be appreciated…. Prognosis? Treatment?

[Physiobase]

Just for general information below is a definition of hemihypotrohpy gained from the website www.medcyclopaedia.com

Hemihypertrophy

enlargement of a limb or one side of the body compared with the contralateral side beyond the limits of normal variation. The distinction from normal is important as some children with congenital hemihypertrophy have an increased risk of malignant abdominal tumours, most commonly Wilms. Other tumours include adrenal carcinoma and hepatoblastoma.

Acquired hemihypertrophy associated with injury, infection, radiation or inflammation is not associated with an increased risk of malignancy.

Hemihypertrophy is rarely apparent at birth but develops as the child grows. Total hypertrophy involves all systems: muscular, vascular, skeletal, neurologic and lymphatic. Ipsilateral paired internal organs are also affected. Limited forms only affect certain somatic structures. Non-syndromic hemihypertrophy is associated with anomalies, particularly genitourinary abnormalities.

The presence of cutaneous and vascular lesions or other clinical features suggests a syndrome such as neurofibromatosis (Fig.1), Klippel Trenaunay syndrome and Parkes Weber syndrome, proteus syndrome or Beckwith Wiedemann syndrome. Non-syndromic hemihypertrophy and Beckwith Wiedemann syndrome (with or without hemihypertrophy) are associated with an increased risk of intra-abdominal malignancy. Regular abdominal ultrasound is therefore recommended in these children. The interval between examinations and age at which screening can be discontinued are controversial. Three to six monthly examinations up to the completion of skeletal growth have been suggested.

It has not been proven that screening improves survival. CT scanograms can be useful to monitor leg length discrepancy.

[1234nale]

Well, the girl is diagnosed as sy hemihyportpophy because the contra lateral side is normal size. She’s been on various diagnostic exams and every one was normal, nothing unusual was finding beside decrease of skeletal growth. The trouble is as she grows the difference in length is bigger.
Only treatment recommended is kinesytherapy treatment, at witch approach nobody knows….Any idea?

[henner223]

Hi Nale,

You are pretty short on your assessment. If you'd be a bit more generous with your info I guess I could contribute sth.

Cheers,

Henner