What's the most likely diagnosis?
- 49 year-old with bilateral arm pain
AP views of both upper extremities
- Shoulder dislocations
- Thalidomide-induced phocomelia
- Holt-Oram Syndrome
- Fibrous dysplasia
- Radiation osteitis
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Answer:
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2. Thalidomide-induced phocomelia
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Thalidomide-induced Phocomelia
General Considerations
- From about 1957-1961, Thalidomide found use in Europe, Japan, Australia and Canada as an anti-emetic during pregnancy until it was found to be a teratogen causing birth defects
- It is estimated that 10,000 babies were born with defects before the drug was banned worldwide
- It is also estimated that 40% died of birth defects
- Fetuses were found to be vulnerable to upper limb phocomelia between days 27-30 of gestation and only a single dose of the drug could produce defects
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