Figure 3.125. Another infant with the fetal akinesia sequence showing the marked lack of dermal ridges and creases. This infant had the typical dysmorphic features of die face, webbing of the neck, and severe intrauterine growth retardation with generalized arthrogryposis.
Figure 3.128. In a body radiograph of die same infant with the fetal akinesia sequence, note die thin gracile ribs, long thin clavicles, and thinning of all the long bones. The soft tissue in the extremities shows a lack of muscle mass. The appearance of the gracile ribs and long clavicles are also seen in trisomy 18 and myotonic dystrophy.
Figure 3.129. This infant with cerebrooculofa-cioskeletal (COFS) syndrome (Pena-Shokeir syndrome type II) presented with generalized hypotonia, hirsutism, characteristic facial features, widely spaced nipples, joint contractures, camptodactyly, and rockerbottom feet.
Figure 3.130. A close-up view of the face of the same infant showing the characteristic facial features. Note the hirsutism, deep-set eyes, prominent root of the nose, upper lip overlapping the lower lip, and micrognathia.
Figure 3.132. In the close-up of the hand of this infant with COFS syndrome in the upper figure note the camptodactyly, and in the lower figure with the hand open, note the absence of finger creases due to lack of fetal movement early in gestation.
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