pivotal step in the management of arthrogryposis multiplex congenita is
to determine its cause. The cause of the arthrogryposis multiplex congenita
determines the prognosis and recurrence rate of the disease. There are
many causes of arthrogryposis multiplex congenita in neonates. Smith’s
book on recognizable patterns of human malformation lists arthrogryposis
multiplex congenita as a feature of over 100 syndromes.
The differential diagnosis among these syndromes is made by analyzing
the distribution of the arthrogryposis, the presence of facial dysmorphism,
and other associated findings.
Figure 152.1.— Trisomy 18 hand position. The middle finger is under the index finger and partially under the fourth finger. The thumb is totally or partially under the index finger.