Abnormalities of the hands and feet in the fetus: sonographic findings.

This pictorial essay illustrates abnormalities of the hands and feet that sonography depicts and describes their associations with chromosomal abnormalities, syndromes, and other pathology. Examination of the extremities, although not listed in the guidelines of the American Institute of Ultrasound in Medicine for standard obstetric sonography, is a critical adjunct to fetal imaging and is needed to diagnose many syndromes. Anomalies of the hands and feet may involve all limbs or be focal, involving a single distal ray. Although this essay focuses on defects of the hands and feet, these defects are often part of more global defects that include the rest of the limb as well. For this reason, anomalies of the limbs that relate primarily to defects of the hands and feet will also be demonstrated. Evaluation of the hands and feet is an important part of the structural survey of the fetus at all gestational ages, as it provides an adjunct to the diagnosis of many syndromes, including chromosomal abnormalities. Even isolated limb anomalies may be important to diagnose antenatally so that proper care can be instituted postnatally for families and their newborns.