SKELETAL MATURATION IN THE CURRENT PEDIATRIC MEXICAN POPULATION

2020 ◽  
Vol 26 (10) ◽  
pp. 1053-1061
Author(s):  
Miguel Klünder-Klünder ◽  
Montserrat Espinosa-Espindola ◽  
Desiree Lopez-Gonzalez ◽  
Mariana Sánchez-Curiel Loyo ◽  
Pilar Dies Suárez ◽  
...  
Keyword(s):  
Middle Childhood ◽  
Skeletal Maturity ◽  
Bone Age ◽  
Mexican Population ◽  
Growth Potential ◽  
Skeletal Maturation ◽  
Chronological Age ◽  
Greulich And Pyle ◽  
Reference Curves ◽  
End Of Puberty

Objective: The most commonly used methods for bone age (BA) reading were described in the Caucasian population decades ago. However, there are secular trends in skeletal maturation and different BA patterns between ethnic groups. Automated BA reading makes updating references easier and more precise than human reading. The objective of the present study was to present automated BA reference curves according to chronological age and gender in the Mexican population and compare the maturation tempo with that of other populations. Methods: The study included 923 healthy participants aged 5 to 18 years between 2017 and 2018. A hand radio-graph was analyzed using BoneXpert software to obtain the automated BA reading according to Greulich and Pyle (G&P) and Tanner-Whitehouse 2 (TW2) references. We constructed reference curves using the average difference between the BA and chronological age according to sex and age. Results: The G&P and TW2 automated reference curves showed that Mexican boys exhibit delays in BA during middle childhood by 0.5 to 0.7 (95% confidence interval [CI], −0.9 to −0.2) years; however, they demonstrate an advanced BA of up to 1.1 (95% CI, 0.8 to 1.4) years at the end of puberty. Mexican girls exhibited a delay in BA by 0.3 to 0.6 (95% CI, −0.9 to −0.1) years before puberty and an advanced BA of up to 0.9 (95% CI, 0.7 to 1.2) years at the end of puberty. Conclusion: Mexican children aged <10 years exhibited a delay in skeletal maturity, followed by an advanced BA by approximately 1 year at the end of puberty. This may affect the estimation of growth potential in this population. Abbreviations: BA = bone age; CA = chronological age; G&P = Greulich and Pyle; TW2 = Tanner-Whitehouse 2

scholarly journals A quantitative method for the radiological assessment of skeletal maturity using the distal femur

2018 ◽  
Vol 100-B (8) ◽  
pp. 1106-1111 ◽  
Author(s):  
D. M. Knapik ◽  
J. O. Sanders ◽  
A. Gilmore ◽  
D. R. Weber ◽  
D. R. Cooperman ◽  
...  
Keyword(s):  
Distal Femur ◽  
Skeletal Maturity ◽  
Final Height ◽  
Bone Age ◽  
Central Peak ◽  
Chronological Age ◽  
Healthy Children ◽  
Greulich And Pyle ◽  
Femoral Physis ◽  
Peak Value

Aims Using 90% of final height as a benchmark, we sought to develop a quick, quantitative and reproducible method of estimating skeletal maturity based on topographical changes in the distal femoral physis. Patients and Methods Serial radiographs of the distal femoral physis three years prior to, during, and two years following the chronological age associated with 90% of final height were analyzed in 81 healthy children. The distance from the tip of the central peak of the distal femoral physis to a line drawn across the physis was normalized to the physeal width. Results A total of 389 radiographs of the distal femur with corresponding Greulich and Pyle bone ages and known chronological ages were measured. Children reached 90% of final height at a mean age of 11.3 years (sd 0.8) for girls and 13.2 years (sd 0.6) for boys. Linear regression analysis showed higher correlation coefficent in predicting the true age at 90% of final height using chronological age + gender + central peak value (R2 = 0.900) than chronological age + gender (R2 = 0.879) and Greulich and Pyle bone age + gender (R2 = 0.878). Conclusion Chronological age + gender + central peak value provides more accurate prediction of 90% of final height compared with chronological age + gender and Greulich and Pyle bone age + gender. Cite this article: Bone Joint J 2018;100-B:1106–11.

scholarly journals Selective effects of biological and chronological age on the development of cognitive abilities in adolescence

2021 ◽  
Author(s):  
Ilona Kovacs ◽  
Kristof Kovacs ◽  
Patricia Gervan ◽  
Katinka Utczas ◽  
Gyongyi Olah ◽  
...  
Keyword(s):  
Cognitive Abilities ◽  
Skeletal Maturity ◽  
Pubertal Timing ◽  
Working Memory Capacity ◽  
Bone Age ◽  
Gonadal Hormones ◽  
Individual Variability ◽  
Biological Age ◽  
Chronological Age ◽  
Biological Maturity

Adolescent development is not only shaped by the mere passing of time and accumulating experience, it also depends on pubertal timing and the cascade of maturational processes orchestrated by gonadal hormones. Although individual variability in puberty onset confounds adolescent studies, it has not been efficiently controlled for. Here we introduce ultrasonic bone age assessment to estimate biological maturity and disentangle the independent effects of chronological and biological age on adolescent cognitive abilities. Comparing cognitive performance of participants with different skeletal maturity we uncover the striking impact of biological age on both IQ and specific abilities. We find that biological age has a selective effect on abilities: more mature individuals within the same age group have higher working memory capacity and processing speed, while those with higher chronological age have better verbal abilities, independently of their maturity. Based on our findings, bone age is a promising biomarker for adolescent research.

scholarly journals Growth and Pubertal Development in Elite Female Rhythmic Gymnasts

1999 ◽  
Vol 84 (12) ◽  
pp. 4525-4530 ◽  
Author(s):  
N. Georgopoulos ◽  
K. Markou ◽  
A. Theodoropoulou ◽  
P. Paraskevopoulou ◽  
L. Varaki ◽  
...  
Keyword(s):  
Body Fat ◽  
Adult Height ◽  
Pubertal Development ◽  
Optimal Growth ◽  
Bone Age ◽  
Skeletal Maturation ◽  
Chronological Age ◽  
Average Height ◽  
Limited Information ◽  
Rhythmic Gymnasts

Optimal growth depends upon both environmental and genetic factors. Among environmental factors that could alter growth and sexual maturation are stress and intensive physical training. The influence of these factors has been documented in a variety of sports, but there is limited information on rhythmic gymnasts, who have entirely different training and performance requirements. The study was conducted during the 13th European Championships in Patras, Greece, and included 255 female rhythmic gymnasts, aged 11–23 yr. The study included measurement of height and weight, assessment of breast and pubic hair development, estimation of body fat and skeletal maturation, and registration of menarcheal age and parental height. Gymnasts were taller than average height for age, with mean height above and mean weight below the 50th percentile. Actual height sd score was positively correlated to weight sd score (P &lt; 0.001), number of competitions (P = 0.01), and body mass index (BMI; P &lt; 0.001). Predicted adult height sd score was positively correlated to weight sd score (P &lt; 0.001) and negatively to body fat (P = 0.004). There was a delay in skeletal maturation of 1.3 yr (P &lt; 0.001). Pubertal development was following bone age rather than chronological age. The mean age of menarche was significantly delayed from that of their mothers and sisters (P = 0.008 and P = 0.05, respectively), was positively correlated to the intensity of training and to the difference between chronological age and bone age (P &lt; 0.001 and P = 0.002, respectively), and was negatively correlated to body fat (P &lt; 0.001). In the elite female rhythmic gymnasts, psychological and somatic efforts have profound effects on growth and sexual development. Despite these aberrations, adult height is not expected to be affected.

scholarly journals Objective Evaluation of Cervical Vertebral Bone Age— Its Reliability in Comparison with Hand-Wrist Bone Age: By TW3 Method

2013 ◽  
Vol 14 (5) ◽  
pp. 806-813
Author(s):  
Vamsi Nilay Reddy ◽  
Gojja Sreedevi ◽  
CMS Krishna Prasad ◽  
Swaroopa Rani Ponnada ◽  
K Padma Priya ◽  
...  
Keyword(s):  
Skeletal Maturity ◽  
Cervical Vertebrae ◽  
Bone Age ◽  
Objective Evaluation ◽  
Ease Of Use ◽  
Skeletal Maturation ◽  
Potential Growth ◽  
Vertebral Bone ◽  
Therapeutic Decisions ◽  
Lateral Cephalograms

ABSTRACT Aim The aim of this study was to establish the validity of a new method for evaluating skeletal maturation by assessing the 3rd and 4th cervical vertebrae seen in the cephalometric radiograph. Materials and methods This study consisted of a sample of 50 patients in the age group of 8 to 14 years of age. Chronologically, they were divided into six groups, based on the age consisting of a minimum of six to a maximum of 10 subjects. All the patients included in the study were females. The selected subjects were clinically examined and then age and date of birth of the patient in years and months was noted. Then lateral cephalograms and hand-wrist radiographs of the patient were taken on the same day with good clarity and contrast. Results The results suggested that cervical vertebral bone age on cephalometric radiographs calculated with this method is as reliable at estimating bone age as is the Tanner-Whitehouse 3 (TW3) method on hand-wrist radiographs. By determining the cervical vertebral bone age, skeletal maturity can be evaluated in a detailed and objective manner with cephalometric radiographs. Conclusion The ability to accurately appraise skeletal maturity from cervical vertebral maturation, without the need for additional radiographs, has the potential to improve orthodontic diagnostic and therapeutic decisions. The technique's simplicity and ease of use should encourage this method as a first level diagnostic tool to assess skeletal maturation. Clinical significance This study revealed that the timing and sequence of ossification of the bones in hand and wrist and cervical vertebrae were able to relate the skeletal development of the various skeletal maturity indicators to a child's development. This method provided a mean with which one can determine the skeletal maturity of a person and thereby determine whether the possibility of potential growth existed. How to cite this article Prasad CMSK, Reddy VN, Sreedevi G, Ponnada SR, Priya KP, Naik BR. Objective Evaluation of Cervical Vertebral Bone Age—Its Reliability in Comparison with Hand-Wrist Bone Age: By TW3 Method. J Contemp Dent Pract 2013;14(5):806-813.

scholarly journals In Boys with Abnormal Developmental Tempo, Maturation of the Skeleton and the Hypothalamic-Pituitary-Gonadal Axis Remains Synchronous

2004 ◽  
Vol 89 (1) ◽  
pp. 236-241 ◽  
Author(s):  
Armando Flor-Cisneros ◽  
Ellen W. Leschek ◽  
Deborah P. Merke ◽  
Kevin M. Barnes ◽  
Marilena Coco ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Congenital Adrenal Hyperplasia ◽  
Short Stature ◽  
Precocious Puberty ◽  
Bone Age ◽  
Skeletal Maturation ◽  
Chronological Age ◽  
Adrenal Hyperplasia ◽  
Normal Bone ◽  
Primary Mechanism

The primary mechanism that initiates puberty is unknown. One possible clue is that pubertal maturation often parallels skeletal maturation. Conditions that delay skeletal maturation also tend to delay the onset of puberty, whereas conditions that accelerate skeletal maturation tend to hasten the onset of puberty. To examine this relationship, we studied boys with congenital adrenal hyperplasia (n = 13) and familial male-limited precocious puberty (n = 22), two conditions that accelerate maturational tempo, and boys with idiopathic short stature (n = 18) in which maturational tempo is sometimes delayed. In all three conditions, the onset of central puberty generally occurred at an abnormal chronological age but a normal bone age. Boys with the greatest skeletal advancement began central puberty at the earliest age, whereas boys with the greatest skeletal delay began puberty at the latest age. Furthermore, the magnitude of the skeletal advancement or delay matched the magnitude of the pubertal advancement or delay. This synchrony between skeletal maturation and hypothalamic-pituitary-gonadal axis maturation was observed among patients within each condition and also between conditions. In contrast, the maturation of the hypothalamic-pituitary-gonadal axis did not remain synchronous with other maturational processes including weight, height, or body mass index. We conclude that in boys with abnormal developmental tempo, maturation of the skeleton and the hypothalamic-pituitary-gonadal axis remains synchronous. This synchrony is consistent with the hypothesis that in boys, skeletal maturation influences hypothalamic-pituitary-gonadal axis maturation.

Prepubertal Growth and Skeletal Maturation in Children With Sickle Cell Disease

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 124-132
Author(s):  
Michael C. G. Stevens ◽  
Gillian H. Maude ◽  
Lena Cupidore ◽  
Helen Jackson ◽  
Richard J. Hayes ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Skeletal Maturity ◽  
Pubertal Development ◽  
Bone Age ◽  
Skeletal Maturation ◽  
Similar Data ◽  
Cell Disease ◽  
Normal Children ◽  
Normal Mean ◽  
Benign Nature

In a longitudinal study of 298 children with homozygous sickle cell (SS) disease and 157 children with hemoglobin SC disease, between birth and 9 years of age, observations of weight and height were made. These were compared with similar data derived from an age- and sex-matched group of 231 children with a normal hemoglobin (AA) genotype. Growth in children with SC disease was not significantly different from that in normal children, but children with SS disease had statistically significant, and progressive, deficits in both weight and height before 2 years of age. The average deficit approached 1 SD below the normal mean for age by 9 years. Observations of skeletal maturity, based on radiologic assessment of bone age at the wrist, were made on a proportion of these children at 5 and 8 years of age. Children with SS disease were significantly retarded at 8 years but not 5 years, which is consistent with increasing deficit in height. These observations confirm the early impact of SS disease on physical development and provide standards from which clinical expectations of growth may be derived. The relevance of these findings and their relationship to the characteristic delay in pubertal development is discussed together with a review of possible etiologic factors. The benign nature of SC disease is endorsed by the absence of an effect on growth in the prepubertal child.

Bone Age

1993 ◽  
Vol 14 (4) ◽  
pp. 133-158
Keyword(s):  
Bone Age ◽  
The Body ◽  
Skeletal Age ◽  
Skeletal Maturation ◽  
Healthy Children ◽  
Left Hand ◽  
Greulich And Pyle ◽  
Ossification Centers ◽  
Greulich And Pyle Method

Skeletal maturation is expressed as bone age or skeletal age. Bone age is based on the orderly appearance of the ossification centers and, therefore, on the successive stages of the development (or maturity) of the skeleton as seen on radiographs. This is not a measure of size, but rather of shape and position. There are many methods of estimating bone age, and almost any part of the body can be used. The hand and wrist are the most practical and the most often used. The Greulich and Pyle method employs an atlas of examples of radiographs of the entire left hand and wrist of healthy children at various ages.

Association between a History of Inhibitors and Delays in Skeletal Maturation in Adolescents with Hemophilia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1022-1022 ◽  
Author(s):  
Sharyne M. Donfield ◽  
Alice Lail ◽  
Edward D. Gomperts ◽  
W. Keith Hoots ◽  
Erik Berntorp ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Bone Age ◽  
Physical Growth ◽  
Skeletal Maturation ◽  
Chronological Age ◽  
Growth Delay ◽  
Hiv Positive ◽  
P Values ◽  
History Of ◽  
Hiv Negative

Abstract The development of inhibitory antibodies to factor VIII or factor IX is the most serious complication of replacement therapy for people with hemophilia. Inhibitors decrease effectiveness of treatment, increasing risk of morbidity including bleeding frequency and arthropathy, and mortality. The current study examined the association between history of inhibitors and physical growth measured by skeletal maturation (bone age, BA) in participants enrolled in the longitudinal Hemophilia Growth and Development Study (HGDS). The HGDS is a population-based multicenter study of children and adolescents enrolled between 1989 and 1990. Participants not skeletally mature (n=306) were included in this investigation. Their mean age was 12, range 7–18 years. Seventy-five percent had severe hemophilia, 19% moderate, and 6% mild. Eighteen percent (n=54) had a history of inhibitors, with maximum lifetime Bethesda titers ranging from 1 to 2048. In general, HGDS participants received on-demand therapy prior to and during study follow-up. Skeletal maturation was determined centrally from x-rays of the hand-wrist according to the Fels method. Readers were masked to the clinical status of participants. Growth delay was defined as chronological age (age) minus BA and modelled using a longitudinal mixed effects polynomial model including age, race, HIV and inhibitor status, and their interactions. P-values were adjusted for multiple comparisons using Scheffe’s method. At every year evaluated (10 through 16), growth delay was greater among HIV-negative subjects with a history of inhibitors compared to HIV-negative subjects without inhibitors (p-values ranged from 0.042 to 0.12). The greatest differences, 9 to 10 months, were observed during the period of expected maximum growth velocity, 12 through 14 years of age (all p&lt;0.05). At ages 15 and 16, subjects with inhibitors lagged approximately 9 months behind those without inhibitors in their skeletal maturation (p=0.067 and 0.12). The predicted BA of HIV-negative adolescents without inhibitors was quite similar to age during this period. At 12, 13, 14, 15 and 16 years, they were 11.9, 13.1, 14.3, 15.4, and 16.4 respectively. Previous investigations from the HGDS have reported delays in skeletal maturation associated with HIV. In this study, delays were greater among HIV-positive subjects with an inhibitor compared to HIV-positive subjects without an inhibitor at every age, but perhaps due to intervening effects of HIV, the differences were generally small (1 to 2 months) and not statistically significant. In conclusion, the differences in bone age relative to chronological age between the HIV-negative groups suggest that a history of inhibitors is associated with delays in onset of puberty. Further investigation of this association and other growth parameters is a priority. If confirmed, the observation has important clinical, epidemiologic and therapeutic implications for the children and adolescents most severely impacted by hemophilia.

scholarly journals PREVALENCE OF CONCOMITANT PATHOLOGY IN SKELETALLY IMMATURE PATIENTS WITH ANTERIOR CRUCIATE LIGAMENT TEARS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
Laura A. Vogel ◽  
Regina O. Kostyun ◽  
J. Lee Pace ◽  
Jonathan D. Gelber ◽  
Carl W. Nissen
Keyword(s):  
Anterior Cruciate Ligament ◽  
Skeletal Maturity ◽  
Cruciate Ligament ◽  
Bone Age ◽  
Surgical Reconstruction ◽  
Chronological Age ◽  
Skeletally Immature ◽  
Young Athletes ◽  
Patient Demographics ◽  
Anterior Cruciate

Background: Historically, anterior cruciate ligament (ACL) injuries in children were treated non-operatively with delayed surgical reconstruction. More recently, there has been increasing literature that suggests delaying surgical reconstruction after ACL injury results in inferior outcomes and increased secondary meniscal and chondral injury in young athletes. Multiple studies have focused on the rates of these concomitant injuries in young athletes, but many of these studies include older athletes nearing or at the point of skeletal maturity and few include skeletal bone age determination. Thus, the rates of concomitant pathology in skeletally immature patients is unknown. The purpose of this study was to describe the prevalence of concomitant pathology found in a group of skeletally immature and compare them to a similar group of skeletally mature patients undergoing ACL reconstruction. Methods: The surgical case log for four orthopaedic surgeons within the sports medicine department of a children’s hospital were reviewed over a ten-year period. Patients were grouped based on skeletal maturity; skeletally immature (SI), approaching skeletal maturity (AM), and skeletally mature (SM). Operative diagnoses were obtained from the operative reports. Patient demographics including sex, bone and chronological age as well as injury and surgical dates were collected from clinical notes. Descriptive statistics were computed for patient demographics and surgical findings. A chi square analysis was completed to understand the prevalence rate among the three groups and a logistical regression was conducted to understanding the association between timing from injury to surgery and presence of concomitant pathology. Results: Our cohort consisted of 535 patients, 66 SI patients (46 males, 20 females; avg chronological age 12.9±1.6 years; avg bone age 13.2 years), 276 AM patients (118 males, 158 females; avg chronological age 15.2±1.2 years; avg bone age 14.9 years), 193 SM patients (107 males, 86 females; avg chronological age 20.3±6.0 years). All patients in the SI group were treated with a physeal sparing technique (61 patients - hybrid sparing technique, 4 patients - femoral and tibial sparing technique, 1 patient - extra-articular reconstruction). Concomitant pathology was present in 38% of SI patients compared to 52% of AM patients and 57% of SM patients. Meniscal injury was the predominant concomitant pathology in the SI group (37.9%); only a single patient had a second ligament reconstructed in addition to their ACL. In comparison, meniscal pathology was also the predominant concomitant pathology in both the AM (48.9%) and SM (51.8%) groups along with chondral lesions (AM 2.2%, SM 3.1%) and multi-ligament injuries (AM 0.4%, SM 4.1%). Lateral meniscal injuries were seen more often than medial meniscal injuries for all groups. A statistical difference was found between groups for the prevalence of concomitant pathology, with the SI group having less than the AM group (p = 0.042) and SM group (p = 0.007). The average time from injury to surgery was shorter for SI patients, 60±43 days compared to 105±208 days (AM group) and 123±185 days (SM group). The results of the logistical regression did not show an association between days from injury to surgery and presence of concomitant pathology in the SI group, but did reveal an association for the AM (p = 0.004; OR 1.004) and SM (p = 0.013; OR 1.002) groups. Conclusion: This is the first article that compares the rates of concomitant pathology in a well-defined group of skeletally immature patients undergoing ACL reconstruction surgery to a skeletally mature cohort. We found that skeletally immature patients had less concomitant pathology than skeletally mature patients.

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