Evaluation of Practical Use of Bone Age Assessments Based on DXA-Derived Hand Scans in Diagnosis of Skeletal Status in Healthy and Diseased Children

Płudowski, Paweł; Lebiedowski, M; Lorenc, R

doi:10.1385/jcd:8:1:048

Cited by 28 publications

(21 citation statements)

References 21 publications

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“…Because the expected age of this critical period of mineralization is similar to the age seen in the outliers of our cohort, our data may suggest that the rate of bone accretion is changing such that a small difference in maturity (BA vs. CA) greatly impacts the expected BMD. Thus, similar to a previous report, the accuracy of a CA derived BMD in peri-pubertal males (healthy or not) is of concern[9] and may warrant adding BA adjustment to BMD evaluations for children exhibiting extremes of growth velocities.…”

Section: Discussionsupporting

confidence: 66%

“…[8] In children with abnormal physiologic maturation, the applicability of CA is even more uncertain. [9] Pediatric endocrinologists commonly use estimations of bone age (BA) in the clinical evaluation and monitoring of aberrant growth patterns. Because BA is presumed to better correlate with physiologic maturity, some investigators have proposed using this measurement rather than CA when interpreting BMD values in children.…”

Section: Introductionmentioning

confidence: 99%

“…Because BA is presumed to better correlate with physiologic maturity, some investigators have proposed using this measurement rather than CA when interpreting BMD values in children. [9,10]…”

Section: Introductionmentioning

confidence: 99%

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The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

et al. 2008

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Background-Skeletal bone accretion occurs throughout childhood. The integrity of this process may influence future adult bone health and risk for osteoporosis. Although surveillance of children who are at risk for poor bone accretion is important, the most appropriate method to monitor childhood bone health is not yet established. Previous investigators have proposed using bone age (BA) rather than chronologic age (CA) when interpreting bone mineral density (BMD) values in children.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

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The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

et al. 2008

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“…Skeletal age, a metric of skeletal maturation, can be used to diagnose developmental delay (Pludowski et al, 2005), predict adult stature (Roche et al, 1975a, 1988; Tanner et al, 1975b) and inform treatment decisions that depend on how close a child is to their pubertal growth spurt (Spadoni & Cianfarani, 2010). Also, in both clinical and epidemiological studies, skeletal age explains a portion of the between-child variation observed in body composition, physical status and performance (Beunen et al, 1992; Claessens et al, 2006; Malina et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

An update of the statistical methods underlying the FELS method of skeletal maturity assessment

Nahhas

Sherwood

Chumlea

et al. 2013

Annals of Human Biology

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Background: Evaluation of skeletal maturity provides clinicians and researchers a window into the developmental progress of the skeleton. The FELS method for maturity assessment provides a point estimate and standard error based on 98 skeletal indicators. Aim: This paper outlines the statistical methodology used by the original FELS method and evaluates improvements that address the following: serial correlation in the calibration sample is now considered, a Bayesian estimation method is now employed to improve estimation near ages 0 and 18 years and uncertainty in the calibration due to sampling is now accounted for when computing confidence limits. Subjects and methods: The original FELS method was calibrated using 677 Fels Longitudinal Study participants. In the improved method, serial correlation is accounted for using GEE, a Bayesian analysis with a prior centred on chronological age is used and the bootstrap is used to account for all sources of variation. Results: Accounting for serial correlation resulted in larger slopes for ordinal indicators. The Bayesian paradigm led to narrower confidence limits and a natural interpretation of skeletal age. Sampling variability in the calibration parameters was negligible. Conclusion: Improvements to the statistical basis of the FELS method provide a more effective method of estimating skeletal maturity.

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“…Maturity indicators are findings such as appearance of the ossification centers, specific alterations in the contours of the bones, and the ultimate closure of the growth plates. 11,12 In our review of the literature, we found no studies that evaluated the skeletal maturation by means of bone age determination in children with obstetrical brachial plexus palsy. The purpose of this study was to examine hand-wrist bone age, another aspect of skeletal growth and development of children with obstetrical brachial plexus palsy, with the unaffected side used as each subject's control, and analyze the results in relation with chronological age of patient, extent of motor function failure, percentage of limb length discrepancy, level of brachial plexus injury, and presence of avulsion.…”

mentioning

confidence: 97%

Bone Age in Children With Obstetrical Brachial Plexus Palsy

Oktay

Cömert²,

Gökkaya³

et al. 2013

J Child Neurol

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The purpose of this retrospective study was to analyze the effect of peripheral nerve injury on the skeletal maturation process. The bone ages of the affected and unaffected hand-wrists of 42 children with obstetrical brachial palsy were determined according to the Greulich and Pyle atlas. In 23 patients, the bone ages of the both sides were identical (bone-age-symmetrical group), in 19 patients the bone age of the affected side was delayed (bone-age-delayed group). The mean bone age of the affected side was delayed 0.48 ± 0.25 years that of the unaffected side (P = .000), and the delay of bone age was inversely correlated with chronological age (R (2) = .45, P < .02) in the bone-age-delayed group. Skeletal retardation can be recognized after appearance of ossification centers by plain radiography, dating from the third month of life, in early infancy. Thus, bone age determination method might be helpful for predicting potential future limb shortness.

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Evaluation of Practical Use of Bone Age Assessments Based on DXA-Derived Hand Scans in Diagnosis of Skeletal Status in Healthy and Diseased Children

Cited by 28 publications

References 21 publications

The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

An update of the statistical methods underlying the FELS method of skeletal maturity assessment

Bone Age in Children With Obstetrical Brachial Plexus Palsy

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