Currently, determination of bone age by x-ray of the brush is important in the diagnosis of a large number of pathologies in children. As a rule, the assessment of this indicator is based on the study of the degree of ossification of the skeleton. After receiving the diagnostic results, the doctor compares them with special atlases. Moreover, the latter takes into account not only the weight and height of the child, but also the circumference of the chest, as well as puberty.
Indications
Doctors can draw up a referral for determining bone age from an x-ray of the brush (photo of the image is presented below) if there are suspicions that the patient’s physical development does not comply with generally accepted standards.
During the study, the following can be identified:
- Slow growth.
- Pathology of the pituitary gland.
- Diseases of the hypothalamus.
- Impaired thyroid function.
- Dwarfism.
- Early puberty.
- Violation of the development of bone structures that arose against the background of the pathology of a genetic nature (for example, adrenal hyperplasia or Shereshevsky-Turner syndrome).
Endocrinologists, orthopedists and pediatricians can send for diagnosis. They are also engaged in the analysis of bone age by x-ray of the brush.
Diagnostic significance
Over the past few decades, doctors are increasingly faced with the phenomenon of acceleration. This term refers to the acceleration of physical development. In this regard, a new approach was developed to assess bone age by x-ray of the brush.
Currently, doctors can identify many pathologies by studying the constitution and physiological condition of the person being studied. To accurately determine the bone age from a radiograph of a brush, it is sufficient for specialists to evaluate the following indicators: size, degree of ossification, as well as the ratio of the structures of the studied zone and the distal forearm.
This diagnostic method is of great value. During the study, the doctor can determine whether the bone age is behind the biological age or, on the contrary, ahead of it. Most often, endocrinologists send for diagnosis. This is due to the fact that they can confirm or exclude the presence of many pathologies, only by studying the radiograph of the brush. Bone age lags behind or ahead of the biological age due to the development of chromosomal diseases in the child’s body, cerebral and pituitary dwarfism, adrenal tumors, etc. In addition, mismatch of indicators can occur due to impaired sexual differentiation.
Determination of bone age by x-ray of the brush also allows you to control treatment with hormonal drugs, especially those that are prescribed to stimulate growth.
Thus, the study is conducted not only to identify various pathologies of the musculoskeletal system and organs of the endocrine system. With it, you can control the degree of effectiveness of the prescribed treatment and, if necessary, make timely adjustments to it.
Algorithm
The technique is standard and does not have any specific features. The child is placed on a special sliding table or stands next to him. The doctor suggests putting the patient’s hand on the equipment so that the wrist and wrist joint are clearly visible in the picture. After this, the child’s body is closed with protective devices that prevent the penetration of x-rays into the body.
At the final stage, the doctor takes a picture. The image with the conclusion the next day is transmitted to the attending physician.
Interpretation of Results
Only a specialist can decipher the radiographs of the brush. Bone age is determined by many criteria. The doctor compares the results with special atlases.
It is important to know only that if the formed sesamoid bone of the metacarpophalangeal joint is clearly visualized in the picture, this indicates hyperfunction of the gonads. Against the background of this process, girls begin to menstruate, while boys are characterized by frequent episodes of pollutions. With ossification of the sesamoid bone, growth jumps are most often observed. The body length of the child increases significantly in a short period of time. In this case, it is customary to talk about premature puberty. If the production of growth hormone, on the contrary, is slow, this indicates a delay in development.
When evaluating the results, the doctor takes into account both age and gender characteristics. It is proved that the female skeleton develops much faster than the male. Moreover, the difference is about one to two years.
To confirm or exclude pathologies of the pituitary gland, an x-ray examination of the Turkish saddle can be prescribed. During the diagnosis, various kinds of diseases and neoplasms can be detected, which are the cause of accelerated or, conversely, slow growth.
With skeletal dysplasia and stunted, genetically determined, a delay in bone age is not observed or it is slightly expressed.
Contraindications
The study is not prescribed for children whose age is less than 14 years. This is due to the fact that ionizing radiation negatively affects a fragile organism. Determining the bone age in babies is possible only if there are serious indications.
In addition, it is important to remember that the study should not be carried out more often than once every six months. This is again explained by the harmful effects of the rays.
Finally
Determination of bone age by x-ray of the brush is an extremely significant study. Based on the diagnostic results, the doctor can identify pathologies not only of the musculoskeletal system, but also of the organs of the endocrine system. Having assessed the degree of ossification, a specialist can determine whether the bone age corresponds to biological age, and also find out the reason for the accelerated or, on the contrary, slowed-down growth of the child. The only contraindication to the study is the age of less than 14 years.