Factors affecting prepubertal and pubertal bone age progression

Abstract

Bone age (BA) is a clinical marker of bone maturation which indicates the developmental stage of endochondral ossification at the epiphysis and the growth plate. Hormones that promote the endochondral ossification process include growth hormone, insulin-like growth factor-1, thyroid hormone, estrogens, and androgens. In particular, estrogens are essential for growth plate fusion and closure in both sexes. Bone maturation in female children is more advanced than in male children of all ages. The promotion of bone maturation seen in females before the onset of puberty is thought to be an effect of estrogen because estrogen levels are higher in females than in males before puberty. Sex hormones are essential for bone maturation during puberty. Since females have their pubertal onset about two years earlier than males, bone maturation in females is more advanced than in males during puberty. In the present study, we aimed to review the factors affecting prepubertal and pubertal BA progression, BA progression in children with hypogonadism, and bone maturation and deformities in children with Turner syndrome.

Anabolic-androgenic steroids. Mechanism of action and clinical effects

“…During this stage of maturation, androgens are aromatized into estrogens. 17,18 The time between the onset of puberty and the cessation of growth is shorter in children receiving AAS. 18 The enlargement of the bone diameter and the increase in the cortical layer thickness occur through the deposition of bone matrix on the periosteal side by the action of osteoblasts.…”

“…17,18 The time between the onset of puberty and the cessation of growth is shorter in children receiving AAS. 18 The enlargement of the bone diameter and the increase in the cortical layer thickness occur through the deposition of bone matrix on the periosteal side by the action of osteoblasts. It was previously believed that such a pattern of periosteal accretion was characteristic of bone growth during male maturation.…”

An accurate pediatric bone age prediction model using deep learning and contrast conversion

“…Heterogeneity in skeletal maturation is influenced by a complex interplay of factors, including genetic predispositions, the nutritional and growth status of the child, the onset of precocious puberty, hormonal variations, conditions related to pediatric endocrinology and metabolic disorders, and ailments affecting the musculoskeletal system [1][2][3]. The assessment of bone age, especially through methods that examine growth plates, is crucial not only for identifying precocious puberty and providing benchmarks for growth trajectories and future height predictions but also for managing conditions such as adolescent idiopathic scoliosis and determining the appropriate timing for orthopedic interventions in children with skeletal anomalies [3][4][5][6]. Thus, the appraisal of bone age using standardized methods is paramount for diagnosing, managing, and developing effective therapeutic strategies for these conditions.…”

Deeplasia: deep learning for bone age assessment validated on skeletal dysplasias

“…Although these disorders are individually rare [ 22 ], collectively they affect a large number of children [ 23 ] with an estimated total number of around 25 million worldwide. Especially in such patients, reliable and precise BA estimations are important for the initial assessment and monitoring of the maturation progress over time [ 24 ]. As skeletal dysplasias alter hand morphology, conventional methods relying on the identification of individual bones or ROIs might be unsuitable for precise BA assessment.…”