Abstract
Bone age is a measure of skeletal maturity, evaluated with an X-ray radiograph of a child’s left hand and wrist. Bone age assessment has two main purposes: first, it allows for assessment of sexual maturity, and second, it can allow for estimation of future growth potential and expected adult height. As such, its primary applications relate to the assessment and workup of disorders of growth and/or puberty. This chapter describes the anatomical and physiologic principles underlying bone age, factors that generally lead to delayed or advanced bone ages, methods of bone age determination, common clinical scenarios in which bone age assessment may be useful, and the use of bone age for height prediction.
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De Sanctis V, Di Maio S, Soliman AT, Raiola G, Elalaily R, Millimaggi G. Hand X-ray in pediatric endocrinology: skeletal age assessment and beyond. Indian J Endocrinol Metab. 2014;18(Suppl 1):S63–71.
Creo AL, Schwenk WF 2nd. Bone age: a Handy tool for pediatric providers. Pediatrics. 2017;140(6)
de Groot CJ, van den Berg A, Ballieux B, Kroon HM, Rings E, Wit JM, et al. Determinants of advanced bone age in childhood obesity. Horm Res Paediatr. 2017;87(4):254–63.
De Leonibus C, Marcovecchio ML, Chiavaroli V, de Giorgis T, Chiarelli F, Mohn A. Timing of puberty and physical growth in obese children: a longitudinal study in boys and girls. Pediatr Obes. 2014;9(4):292–9.
Denzer C, Weibel A, Muche R, Karges B, Sorgo W, Wabitsch M. Pubertal development in obese children and adolescents. Int J Obes. 2007;31(10):1509–19.
He Q, Karlberg J. Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res. 2001;49(2):244–51.
Sopher AB, Jean AM, Zwany SK, Winston DM, Pomeranz CB, Bell JJ, et al. Bone age advancement in prepubertal children with obesity and premature adrenarche: possible potentiating factors. Obesity (Silver Spring). 2011;19(6):1259–64.
Lee HS, Shim YS, Jeong HR, Kwon EB, Hwang JS. The association between bone age advancement and insulin resistance in Prepubertal obese children. Exp Clin Endocrinol Diabetes. 2015;123(10):604–7.
Spadoni GL, Cianfarani S. Bone age assessment in the workup of children with endocrine disorders. Horm Res Paediatr. 2010;73(1):2–5.
Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. Palo Alto: Stanford University Press; 1959.
Tanner JM, Whitehouse RH, Cameron N, Marshall WA, Healy MJR, Goldstein H. Assessment of skeletal maturity and prediction of adult height (TW2 method), Ed 2. London: Academic Press; 1983.
van Rijn RR, Thodberg HH. Bone age assessment: automated techniques coming of age? Acta Radiol. 2013;54(9):1024–9.
Ontell FK, Ivanovic M, Ablin DS, Barlow TW. Bone age in children of diverse ethnicity. AJR Am J Roentgenol. 1996;167(6):1395–8.
Mora S, Boechat MI, Pietka E, Huang HK, Gilsanz V. Skeletal age determinations in children of European and African descent: applicability of the Greulich and Pyle standards. Pediatr Res. 2001;50(5):624–8.
Eitel KB, Eugster EA. Differences in bone age readings between pediatric endocrinologists and radiologists. Endocr Pract. 2020;26(3):328–31.
Thodberg HH, Kreiborg S, Juul A, Pedersen KD. The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging. 2009;28(1):52–66.
Thodberg HH, Jenni OG, Caflisch J, Ranke MB, Martin DD. Prediction of adult height based on automated determination of bone age. J Clin Endocrinol Metab. 2009;94(12):4868–74.
DeSalvo DJ, Mehra R, Vaidyanathan P, Kaplowitz PB. In children with premature adrenarche, bone age advancement by 2 or more years is common and generally benign. J Pediatr Endocrinol Metab. 2013;26(3–4):215–21.
Bayley N, Pinneau SR. Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards. J Pediatr. 1952;40(4):423–41.
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McGill, D. (2021). Bone Age. In: Stanley, T., Misra, M. (eds) Endocrine Conditions in Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-52215-5_36
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DOI: https://doi.org/10.1007/978-3-030-52215-5_36
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