The child looks short and slow. Do you need to measure the age of bone?

It is not recommended that children who develop normally under the age of 6 will conduct conventional bone age examinations.

Bone Age (BA), also known as bone age or biological age, is to reflect the degree of physical development by determining the size, form, structure, and mutual relationship of the bones.

To understand it simply, bone age is to determine the age of development with the development of bones.

Testing bone age requires a X -ray film with a left hand (including the palm finger wrist joint), and then handed it to the doctor for evaluation.

Picture source: G-P bone age diagram

So, is it necessary for parents to take their children to check bone age?

From a professional perspective, children who develop normally under the age of 6 are not recommended to conduct routine bone age examinations [1].

If there is the following situations, after being evaluated by a specialist, bone age examination may be performed [2]:

Height is too short

To meet or approach the standards of dwarf, that is, in the similar living environment, the same race, the same gender, and the same age, the height is lower than the average height difference between the normal population, or the 3 % level (can be possible (can be possible (can It is understood as an average of 100 people, from short to high row to the top three).

Tall height

比同龄人高，即比同种族、同性别和同年龄的正常人群平均身高，大2 个标准差，或大于第97 百分位（可以理解为平均每100 人，从矮到高排，排To the last three).

Height deviates from parents' genetic target

Although the height is in normal range, it is far from the curve of the height of the height of the height of the parents from the parents.

Children's genetic target height calculation method is:

Girls = [Mother's height CM + (Father's height CM-13)] / 2

Boy = [Father's height CM+(Mother's height CM+13)] / 2

For example, the father is 180cm tall and the mother is 170cm tall, and the height of the baby is located at the middle of the normal crowd. Even if it belongs to the normal range, it is not in line with genetic factors. This situation also needs to check bone age, and vice versa.

The annual height growth rate is too fast or too slow

Although the height is normal at present, the height growth rate is too slow or too fast every year.

The growth rate is too slow:

<7.0 cm / year among children

2 to 4 years old children <5.5 cm / year

4 ～ <6 -year -old child <5.0 cm / year

Children at the age of 6 to adolescence <4.0 cm / year

Adolescent children <6.0 cm / year consider growing slowly.

Excessive growth rate refers to:

2 to 4 years old & 9 cm / year,

4 to 6 years old & 8.5 cm / year,

6 years old to adolescence: boy & 6 cm / year, girl & 6.5 cm / year.

Premature second sexual character

If the girl starts to develop before the age of 8, and experience the first menstrual tide before the age of 10, the testicular volume of the boy before the age of 9, considering precocious puberty, also needs to perform bone age examination.

The second sex appears too late

That is, the girl has no breast development at the age of 13, and the boy at the age of 14 has no testicular development, or the development progress is too slow. For example, girls have developed for more than 4 years, and they have no early menstrual tide.

I'm receiving disease treatment

During the treatment of diseases such as short body and precocious puberty, it is also necessary to regularly shoot bone age to judge the curative effect.

Abnormal body ratio

Babies have short limbs, special faces and skeletal malformations. When doctors think that it is necessary, bone age examination is needed.

references

[1] The endocrine genetic metabolism group of the Chinese Medical Association Pediatrics Branch, the Child Health Health Student Group of the Pediatrics of the Chinese Medical Society, the Editorial Committee of the Chinese Pediatric Magazine. Volume 59, Phase 3, 169-174, Medline IStic PKU CSCD, 2021.

[2] Pediatric clinical thinking [M]. Science Press, Yi Zuwen, 2019

Experts in this article

Liu Fang

Cooperative expert

Deputy Chief Physician of Child Health Care and Development of Binzhou Medical College Affiliated Hospital

Zhu Jie

Review expert

Zhuo Zheng Medical Children's Endocrine/Children's Health Doctor

Plan

Produced: MEI

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