Celery Stalk Appearance

Celery Stalk Lesions And Rubella

Figure 2.135. Radiograph composite that demonstrates the types of bony changes found in congenital rubella syndrome: from left to right, A) "celery stalk" appearance; B) nonspecific growth arrest lines; C) a bony spicule at the medial condyle of the femur (an uncommon finding). All of these regress over the first few months postnatally.

Figure 2.135. Radiograph composite that demonstrates the types of bony changes found in congenital rubella syndrome: from left to right, A) "celery stalk" appearance; B) nonspecific growth arrest lines; C) a bony spicule at the medial condyle of the femur (an uncommon finding). All of these regress over the first few months postnatally.

Figure 2.136. Children with congenital rubella may have a normal physical and neurodevelopmental outcome, although it is uncommon. Maternal rubella in the first 4 weeks of pregnancy carries a risk of congenital rubella of 50% (heart anomalies, eye defects, hearing problems, etc.); between the 12th and 16th weeks of pregnancy the risk decreases to 2 to 6%; and between the 18th to 20th weeks of pregnancy the risk is practically nil. Over 80% of babies with congenital rubella shed virus during the first month of life, and 5 to 10% (those severely affected), for one year.

Figure 2.137. Cicatricial skin lesions of the neck and upper back in an otherwise normal infant following maternal varicella at 5 months gestation. These skin lesions are the most common finding after maternal varicella which presents in the 1st and early 2nd trimester. Maternal infection with varicella early in pregnancy is a cause of fetal malformations including reduction deformities of the limbs (hypoplastic limbs and/or contractures) and scars along the length of the affected limbs. The infant may be small for gestational age and demonstrate features of central nervous system involvement (encephalomyelitis) and eye defects (microphthalmia, cataracts, and chorioretinitis).

Figure 2.138. Congenital varicella in an infant which presented at the age of 7 days. Mother developed varicella 10 days prior to delivery. This infant had very few lesions and was not ill. If the onset in the mother is within 4 days prior to or within 48 hours after delivery, or if the onset in the newborn is between 5 to 10 days after birth, the infant's condition is usually more severe. In these cases, varicella-zoster immune globulin (VZIG) should be given as soon as possible after birth.

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