Bone age

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Bone Age is the level of bone maturation of children. When a person grows from the life of the fetus through childhood, puberty, and completes growth as a young adult, the skeletal bones change in size and shape. This change can be seen with x-rays. The "age of the bones" of a child is the average age at which children reach this stage of bone maturation. The current height and bone age can be used to predict adult height. For most people, their bone age is the same as their biological age but for some individuals, their bone ages are several years older or younger. Those with advanced bone ages usually attack early growth but stop growing earlier faster while those with late bone age are hitting their growth more slowly than usual. Children below average height should not have bone age delayed; actually the age of their bones can really go forward which if not addressed, will hamper their growth.

At birth, only metaphysical "long bones" are present. Long bones are bones that grow primarily by elongation in the epiphysis at one end of the growing bone. Long bones include the femurs, tibia, and fibula of the lower extremities, humeral, radii, and ulnas of the upper limb (forearm arm), and the phalanx of the fingers and toes. The long bones of the foot comprise almost half of the adult's height. Other major skeletal bone components are the spine and skull.

As a child grows, epiphyses become calcified and appear on x-rays, like the carpal and tarsal bones of the hands and feet, separated on x-rays by an invisible cartilage layer where most growth occurs. When sex steroid levels increase during puberty, bone maturation accelerates. As growth approaches the conclusion and attainment of adulthood, bone begins to approach the size and shape of the adult bone. The remaining cartilage part of the epiphyses becomes thinner. When these cartilaginate zones are eliminated, epiphisis is said to be "closed" and there will be no further bone lengthening. A small amount of spinal growth concludes a teenager's growth.

Child endocrinologists often order bone x-rays to evaluate children for advanced or delayed growth and development. This is interpreted by pediatric radiologists, physicians who are experts in using medical imaging for pediatric diagnosis and therapy.

Video Bone age

Metode

The most commonly used method is based on a single x-ray of the left hand, finger, and wrist. The hand is easily X-rayed with minimal radiation and shows many bones in one view. Bones in x-rays are compared to the standard atlas bones, usually "Greulich and Pyle".

A more complex method is also based on hand x rays is the "TW2" method or the "TW3" method (TW = Tanner Whitehouse).

An atlas based on knee ripening has also been compiled.

The bone age rating is a suitable procedure for automation by computers. The main advantage is the elimination of the rating variability between different human assessors. The BoneXpert method is the most outstanding example of a fully automated method.

Infant's hands do not change much in the first year of life and if proper bone age assessment is required, x-rays are about half of the skeleton (the "hemiskeleton" view) can be obtained to assess some areas such as the shoulder and pelvis that change more in infancy.

Maps Bone age

High prediction

Statistics have been compiled to show the percentage of remaining high growth at given bone age. With simple arithmetic, the predicted adult height can be calculated from the height and age of the child's bone. Separate tables are used for boys and girls due to gender differences in puberty, and slightly different percentages are used for children with extraordinarily advanced or delayed bone ripening. These tables, the Bayley-Pinneau table, are included as attachments in the Greulich and Pyle atlas.

In a number of conditions involving atypical growth, high predictions of bone age are less accurate. For example, in small children born to gestational age who remain short after birth, bone age is a poor predictor of adulthood.

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Clinical application of bone age reading

The continued or delayed bone does not necessarily indicate "pathological" disease or growth. In contrast, bone age may be normal in some abnormal growth conditions. Children are immature at the same time. Just as there is wide variation among the normal population at the age of missing teeth or having the first menstrual period, the age of a healthy child's bones may be one or two years forward or delayed. Those with advanced bone age usually attack early growth but stop growing at an earlier age. As a result, when a child with a short age has advanced bone age, it inhibits their growth at an early age, making them shorter than they should be. Therefore, those who are short with advanced bone ages, require medical attention before their bones are fully fused.

Bone aging advanced is common when a child has a prolonged increase in sex steroid levels, such as in premature puberty or congenital adrenal hyperplasia.

Bone age is often slightly advanced with premature adrenarche, when a child is overweight from a young age or when a child has lipodystrophy. Those with advanced bone age usually attack early growth but stop growing at an earlier age.

Bone age can be significantly increased in genetic growth syndrome, such as Sotos syndrome, Beckwith-Wiedemann syndrome and Marshall-Smith syndrome.

Bone maturation is delayed with a normal developmental variation called constitutional delay of growth and puberty, but delay also accompanies growth failure due to growth hormone deficiency and hypothyroidism.

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See also

• Growth

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References

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External links

• Automatic bone age determination.
• Full description of the use of bone age film from Utrecht University.
• Bone Age - Free Mac OS X software to assist in radiographic assessment using G & amp standards P.

Source of the article : Wikipedia