Arthrogryposis

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Arthrogryposis is a neuro-musculo-skeletal disorder that affects various joints in the body. The condition is congenital and non progressive. The medical terminology for the disorder is Arthrogryposis Multiplex Congenita.

The joints in the body show contractures, stiffness, poor mobility or immobility and muscle fatigue.

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WHAT CAUSES ARTHROGRYPOSIS?

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• The chief cause for the arthrogryposis is too little room for the fetus to have normal movements. The space within the uterus is inadequate if the mother has an abnormally-shaped uterus or there is not enough amniotic fluid in the uterus. Whatever causal factor impedes normal movements of the joints before birth triggers joint contractures and consequently arthrogryposis. When a joint is kept immobile for a prolonged interval of time, surplus connective tissue develops around it, thus fastening it.

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• Fetal hyperthermia is another significant cause. Hence, if the mother has fever for a protracted time period, or has increased body temperature due to soaking in hot tubs for long periods, it sets off fetal hyperthermia or fetal overheating, also leading to arthrogryposis .

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• An impairment of the nervous system, like spina bifida, spinal muscular atrophy, brain defects, also affects one’s joint mobility.

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• Neuro-muscular ailments such as myasthenia gravis, myotonic dystropy, MS / multiple sclerosis hamper joint movements too.

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• Another vital cause is maternal contact with some substances that are injurious to the fetus, like, drugs, alcohol, or phenytoin.

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SYMPTOMS OF ARTHROGRYPOSIS

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Commonly seen clinical manifestations and symptoms of arthrogryposis are:

• Restricted joint mobility or joint immobility, along with muscle weakness.

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• Notably, the arms and legs are greatly afflicted, the ankle and wrists joints being most affected.

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• Weakness and weariness of the muscles is also seen. The muscles may be emaciated or may even be missing altogether.

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• The hip joint may be displaced.

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• In some children, facial deformities, anomalies of the spinal cord, respiratory and cardiac disorders, abnormality of the genital tract, and skin impairment are also seen.

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HOW TO MANAGE ARTHROGRYPOSIS EFFECTIVELY?

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The effective management of arthrogryposis needs a multi-disciplinary approach. By and large, the treatment regime comprises of surgical intervention, physiotherapy and occupational therapy.

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• Physical therapy: physiotherapy, consisting of stretching, splinting, casting, etc. helps significantly improve the range of movement of the affected joints. Physiotherapy strengthens and reinforces the joints as well as the muscles, thus making the joints more flexible and mobile.

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• Occupational therapy: in addition to stretching, splinting and casting of the joints, occupational therapy incorporates training in fine motor skills and ADL; as well as, tackling psychological and psycho-social repercussions of having a deformity.

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• Surgery: Experts say that, since there are a host of mobility impairments in the patient, customized orthopedic rectification is particularly beneficial.

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Orthopedic surgery, including osteotomy, may be performed to treat severely afflicted joints. What’s more, various other symptoms associated with the disorder, such as club foot, hernia and hip displacement, are also managed through surgical intervention, and these significantly enhance the quality of life.