Long Story of Short Femur: A Single-Center Study with Step-Wise Imaging Approach

• Published in: Journal of ultrasound Vol. 27; no. 3; pp. 433 - 440
• Main Authors: Agarwal, Shubhra, Agarwal, Arjit, Chandak, Shruti
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2024; Springer Nature B.V
• Subjects: Abnormalities; Adult; Algorithms; Cohort Studies; Female; Femur; Femur - diagnostic imaging; Fetal Growth Retardation - diagnostic imaging; Fetuses; Gestational Age; Humans; Medicine; Medicine & Public Health; Original Paper; Pregnancy; Prospective Studies; Ultrasonography, Prenatal - methods; Ultrasound; Aneuploidy; Femur; Skeletal dysplasia; Micromelia; Ultrasound
• ISSN: 1876-7931; 1971-3495; 1876-7931
• DOI: 10.1007/s40477-022-00765-1

Purpose To evaluate the possible outcomes of fetuses diagnosed with short femur length (FL) and to guide diagnosis through a step-wise imaging algorithm. Methods This was a prospective cohort study of 42 pregnancies with fetal femur length (FL) below the 5th centile for gestational age. The cases were divided into two categories of isolated short FL & non-isolated short FL and followed up to determine the etiology. Results There were 11 cases of non-isolated short FL with skeletal dysplasia observed in 7 and chromosomal abnormalities in 4 cases. There were 31 cases with isolated short FL in which fetal growth restriction (FGR) occurred in 14/31 (45%) cases; 13 out of 31 (42%) were constitutional (short for gestational age, SGA) whereas 4/31(13%) showed normal interval growth on follow up (false positive). Conclusion Short femur can be isolated or non-isolated. Short femur length can be a good predictor and early sign of FGR. Serial follow up scan of the all cases of isolated short FL is important since a majority of them are normal and not require any further intervention. Cases of non-isolated short FL require step-wise approach to differentiate into dysplasia or aneuploidy.