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Differential diagnosis of perinatal hypophosphatasia: radiologic perspectives

2018/10/03 by Amaka C Offiah, Amaka C. Offiah, Jerry Vockley +2 · 1 citation
Medicine · #Alkaline Phosphatase Research Studies #Bone health and osteoporosis research #Bone health and treatments

paper · pdf · doi:10.1007/s00247-018-4239-0

openalex publication_date 2018/10/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29

Abstract

Perinatal hypophosphatasia (HPP) is a rare, potentially life-threatening, inherited, systemic metabolic bone disease that can be difficult to recognize in utero and postnatally. Diagnosis is challenging because of the large number of skeletal dysplasias with overlapping clinical features. This review focuses on the role of fetal and neonatal imaging modalities in the differential diagnosis of perinatal HPP from other skeletal dysplasias (e.g., osteogenesis imperfecta, campomelic dysplasia, achondrogenesis subtypes, hypochondrogenesis, cleidocranial dysplasia). Perinatal HPP is associated with a broad spectrum of imaging findings that are characteristic of but do not occur in all cases of HPP and are not unique to HPP, such as shortening, bowing and angulation of the long bones, and slender, poorly ossified ribs and metaphyseal lucencies. Conversely, absent ossification of whole bones is characteristic of severe lethal HPP and is associated with very few other conditions. Certain features may help distinguish HPP from other skeletal dysplasias, such as sites of angulation of long bones, patterns of hypomineralization, and metaphyseal characteristics. In utero recognition of HPP allows for the assembly and preparation of a multidisciplinary care team before delivery and provides additional time to devise treatment strategies.

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