Arthrogryposis

Arthrogryposis is a term used to describe a number of rare conditions characterized by stiff joints and abnormally developed muscles. It’s also referred to as arthrogryposis multiplex congenital, or amyloplasia.

Arthrogryposis is not thought to be a genetic or hereditary condition. The exact cause of arthrogryposis is unknown, but a number of different theories have been proposed:

• Some believe that arthrogryposis is caused by obstructions to intrauterine movement during pregnancy.
• Others believe that it may be a result of an early viral infection during a baby’s development.
• Others believe that arthrogryposis is the result of failure of the central nervous system and/or muscular system to develop appropriately.

Arthrogryposis is a rare condition, though the exact frequency with which it occurs is unknown. Previous studies estimate that it affects one to three of every 10,000 babies.

Each child experience symptoms differently, but here is a list of some common ones:

• The range of motion of the joints in your child’s arms and legs may be limited or fixed.
• Your child’s shoulders may be rotated inward.
• She may have abnormal extension of her elbows.
• She may be able to flex her wrists and fingers abnormally.
• She could have dislocated hips.
• She may have clubfoot.

Your child’s doctor can make a diagnosis after a thorough medical history and careful physical examination.

X-rays often confirm the diagnosis and are helpful when your child’s doctor is evaluating stiff or dislocated joints.

Additional tests, including blood tests, muscle biopsies, and other imaging studies, help doctors confirm the diagnosis.

Your child's doctor may prescribe physical and occupational therapy to increase your child's muscle strength and improve flexibility.

Splints can also increase your child's range of motion. A removable splint works so that the joints can be moved and muscles exercised periodically. In some cases, merely wearing a splint at night may be sufficient.

Surgical options for arthrogryposis

Your child's doctor may recommend surgery to improve how she can position and move her limbs.

These procedures may include muscle releases, tendon transfers, or bone fusions to improve flexibility and correct deformities.

Your child will most likely have persistent muscular and/or joint limitations due to her underlying condition. Unlike many other conditions, arthrogryposis is non-progressive and does not worsen as your child ages.

With physical therapy and other treatments, your child will likely have substantial improvement in her function. Most children go on to lead productive, independent lives as adults.

You can have peace of mind knowing that the skilled experts in our Orthopedics and Sports Medicine Department's Hand and Orthopedic Upper Extremity Program have treated thousands of babies and children with many hand conditions. We provide expert diagnosis, treatment, and care, and we benefit from our advanced clinical and scientific research.

Your child will undergo a course of occupational therapy, which will help improve her flexibility and strength in the joints and muscles. Specialists in the Occupational Therapy Program at Boston Children’s will collaborate with you and your child’s doctor to provide the best possible care for your child.

Treatment programs for arthrogryposis are based on thorough evaluations and are always individualized to meet the needs of your child.