Bone Age Film

Aka: Bone Age Film, Bone Age

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II. Definitions

  1. Bone Age
    1. Growth Assessment tool in the evaluation of abnormal growth

III. Physiology

  1. Bone Age is estimated by ossification patterns
  2. Software tools are available that estimate Bone Age by xray, as well as MRI, Ultrasound and DEXA

IV. Precautions

  1. XRay Bone Age models are based on development of white children
  2. May be inaccurate in non-white ethnicities

V. Indications

  1. Growth Assessment (e.g. Short Stature, Tall Stature)
  2. Failure to Thrive

VI. Technique

  1. Age under 2 years
    1. Knee XRay (Anteroposterior and lateral)
    2. Hand XRay (Anteroposterior and Lateral)
  2. Age over 2 years
    1. Left hand or non-dominant side (anteroposterior)
    2. Left wrist or non-dominant side (anteroposterior)

VII. Interpretation

  1. Bone Age 2 SD above or below Chronological Age suggests a pathological condition
  2. Delayed Bone Age and Short Stature
    1. Constitutional Short Stature
    2. Growth Hormone Deficiency
    3. Hypothyroidism
    4. Celiac Disease
    5. Anemia
    6. Malnutrition
    7. Chronic systemic illness
  3. Normal Bone Age and Short Stature
    1. Familial Short Stature
    2. Idiopathic Short Stature

VIII. References

  1. Creo (2017) Pediatrics 140(6): e20171486 [PubMed]

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