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Joseph Junewick, MD FACR
over 6 years ago
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Accessory Lower Limb

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: 8 months ago
Updated: 8 months ago
Tags: PEDS
Modality/Study Types: CR MR
Activities:
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History

Newborn with protuberant left gluteal mass.


Case Images


Diagnosis

Accessory lower limb

Findings

CR – Abdomen radiograph shows an accessory long bone in left pelvis; specimen radiograph confirms rudimentary limb.

MR – Supernumerary limb on the left.

Discussion

Heterotopic redundancy of the extremities is probably related to mechanical factors (splitting and migration of the limb primordial) but no single exogenous causal factor or genetic link has been identified. Supernumerary limbs are associated with malformations of the neural tube and/or gastrointestinal tract. Leakage of the proteinaceous neural tube fluid may provide an abundant source of totipotential Schwann cells which can dedifferentiate into cartilage, bone, muscles and nerves and eventually an accessory limb.

Reference

Krishna A, Chanda S, Mishra NK, et al: Accesory limb associated with spina bifida. J Pediatr Surg 1989; 24: 604-606.



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