Bone Age Measurement in Pediatric Patients of Universitas Airlangga Hospital from January 2018 to December 2019
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Highlights:
1. There was a significant relationship between bone age calculated by the Tanner Whitehouse II method (TW2-20) and chronological age.
2. There was a slowdown in bone age in pediatric patients at Universitas Airlangga Hospital (RSUA).
Abstract
Introduction: Bone age is an indicator of biological and skeletal maturity in individuals. It is different from chronological age which is calculated based on the time of birth. The differences in chronological age and bone age can indicate abnormalities in bone development. This study aimed to determine the profile of bone age in pediatric patients at Universitas Airlangga Hospital and the relationship between bone ages examined using the Tanner Whitehouse II (TW2-20) method and their chronological ages.
Methods: This was a cross-sectional observational analytic study. Secondary data were collected from medical records and X-Ray examination results from Department of Radiology Universitas Airlangga Hospital (RSUA) Surabaya from January 2018 to December 2019. The data of age, gender, and history of illness were taken. From the collected X-ray results, bone age was examined using the TW2-20 method. Then, a normality test was performed using the Shapiro-Wilk for data less than 50 samples. The results showed that the data were normally distributed (p = 0.419). Data processing of the difference between bone age and chronological age was performed using the parametric paired T-test with a confidence level of 95%.
Results: 32 samples were obtained from pediatric patients undergoing X-ray examinations from January 2018 to December 2019. The average bone age difference in male patients was 0.64 years old with the highest average difference found in the age range of 9-11.99 years old. The average bone age difference in female patients was 1.1 years old with the highest average difference found in the age range of 12-14.99 years old. There was a significant difference between bone age calculated using the TW2-20 method and chronological age (p < 0.001).
Conclusion: Based on the comparison of the average bone age in pediatric patients and their chronological age, all samples showed deceleration of bone age in pediatric patients at RSUA. Based on the analytical study, the TW2-20 method was not suitable for the sample examined.
Cavallo F, Mohn A, Chiarelli F, et al. Evaluation of Bone Age in Children: A Mini-Review. Front Pediatr; 9. Epub ahead of print 12 March 2021.
Yeon KM. Standard Bone-Age of Infants and Children in Korea. J Korean Med Sci 1997; 12: 9–16.
Satoh M. Bone Age: Assessment methods and Clinical Applications. Clin Pediatr Endocrinol 2015; 24: 143–152.
Subramanian S, Viswanathan VK. Bone Age. 2022.
Berendsen AD, Olsen BR. Bone Development. Bone 2015; 80: 14–18.
Gilbert SF. Osteogenesis: The Development of Bones. Sunderland (MA): Sinaur Associates, https://www.ncbi.nlm.nih.gov/books/NBK10056/ (2000).
Prentice A, Schoenmakers I, Laskey MA, et al. Symposium on ‘Nutrition and Health in Children and Adolescents' Session 1: Nutrition in growth and development. Proc Nutr Soc 2006; 65: 348–60.
Khosla S, Oursler MJ, Monroe DG. Estrogen and The Skeleton. Trends Endocrinol Metab 2012; 23: 576–581.
Lindsey RC, Mohan S. Skeletal Effects of Growth Hormone and Insulin-Like Growth Factor-I Therapy. Mol Cell Endocrinol 2016; 432: 44–55.
Long F, Ornitz DM. Development of the Endochondral Skeleton. Cold Spring Harb Perspect Biol 2013; 5: a008334–a008334.
Williams GR, Bassett JHD. Thyroid Diseases and Bone Health. J Endocrinol Invest 2018; 41: 99–109.
Creo AL, Schwenk WF. Bone Age: A Handy Tool for Pediatric Providers. Pediatrics; 140. Epub ahead of print December 2017.
Govender D, Goodier M. Bone of Contention: The Applicability of the Greulich–Pyle Method for Skeletal Age Assessment in South Africa. South African J Radiol; 22. Epub ahead of print 8 August 2018. DOI: 10.4102/sajr.v22i1.1348. [PubMed] [CrossRef]
Tanner JM, Whitehouse RH, Cameron N, et al. Assesment of Skeletal Maturity and Prediction of the Adult Height (TW2 method). London: New York Academic Press, 1983.
Cameron N. The Tanner-Whitehouse II Skeletal Maturity Method: Rationale and Applicability. Clin Pediatr Endocrinol 1993; 2: 9–18.
Mughal AM, Hassan N, Ahmed A. Bone Age Assessment Methods: A Critical Review. Pakistan J Med Sci; 30. Epub ahead of print 31 December 1969.
Prokop-Piotrkowska M, MarszaÅ‚ek-Dziuba K, MoszczyÅ„ska E, et al. Traditional and New Methods of Bone Age Assessment-An Overview. J Clin Res Pediatr Endocrinol 2021; 13: 251–262.
Aichinger H, Dierker J, Joite-BarfuíŸ S, et al. Radiation Exposure and Image Quality in X-Ray Diagnostic Radiology. Berlin, Heidelberg: Springer Berlin Heidelberg. Epub ahead of print 2012.
Bhat A, Acharya A, Kumar B. Radiographic Imaging of the Wrist. Indian J Plast Surg 2011; 44: 186.
Benjavongkulchai S, Pittayapat P. Skeletal Age Estimation in A Group of Contemporary Thai Children and Adolescents using Tanner-Whitehouse 3 (TW3) Method. JDAT DFCT; 67, http://www.dent.chula.ac.th/upload/images2/graduate/5875839832.pdf (2017).
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