Assessment of bone age also helps predict adult height. Healthy children of the same sex and at the same calendar age can be very different from each other in terms of their level of physical development. These differences become more evident in the age period when changes related to puberty begin to occur, and bone age determination comes to our aid here. Determination of bone age by looking at the bone age atlas can be applied when the appearance of the bones is basically normal; This method cannot be applied if the bones are out of shape or damaged, such as in severe skeletal dysplasia, severe metabolic disorders, or joint diseases affecting the hands. Bone age; It is useful in short stature, tallness, evaluation of puberty, determination of growth potential and final height to be reached. We can assume that if the bone age is higher than the chronological age of the adolescent, the height increase will be less. However, it should be clearly distinguished whether the degree of delay or progression in bone age is due to physiological variability or is due to pathological conditions.
There may be differences of up to 1-2 years between the calendar age and the bone age in healthy children. In hypothyroidism, growth hormone deficiency, puberty delay; In chronic diseases such as malnutrition, malabsorption, metabolic disorders, and skeletal dysplasia diseases, bone age is lower than the calendar age. Bone age in obese children is greater than chronological age. The most obvious condition in which bone age is advanced is precocious puberty.
Bone age progression due to early puberty or inappropriate use of androgens or estrogens are the most important causes that reduce growth potential and adult height. In the long-term treatment of precocious puberty, the change in bone age is an aiding factor in the treatment.
Should Bone Age Be Checked Every Year in Healthy Children?
Under normal conditions, bone age in healthy children, year by year, is observed. progresses almost parallel to chronological age, but this changes in adolescence, because this increase in stature At the fastest growing age, bone age also progresses much faster than the previous rule of "one bone age to one calendar year".
If puberty is delayed, the rate of bone age progression slows down, and if puberty starts at an early age, bone age progression is also earlier. Certainly; there comes an age when no further growth is possible; The indicator of this is the fusion of the growth cartilages in the hand-wrist radiograph with the bone ends, that is, their closure. This is a result of puberty and occurs with the effect of estrogen in girls and testosterone in boys. p> In adolescence, there is a situation called the puberty growth spurt, which occurs right after the onset of breast development in girls. The growth spurt in boys starts 2 years later than girls. Puberty growth spurt or puberty height increase, which starts with breast enlargement in girls, is usually completed until the first menstruation.
After menstruation, girls grow 5–6 cm on average. Boys, on the other hand, are more fortunate than girls in terms of puberty growth spurt or puberty height increase, their height increase is greater. In men, the increase in height continues until the age of 18-19, albeit at a decreasing rate. In adolescence growth spurt, the 'peak growth rate period', in which the fastest growth occurs, is a period in which there is an increase in height of 8-10 cm in an average short time.
The ages at which this fastest increase in height is observed are 11.5–12.5 years old just before the first menstruation in girls and 13–14 years in boys. The fastest height increase in girls occurs 2 years before boys, and the age of the fastest increase in height may vary according to the early or late onset of puberty, but it is usually similar to maternal or paternal characteristics.
How Does the Period of Adolescence Affect Height Growth?
Adolescence is a process that normally takes 3-5 years. During this time, height increases, but puberty is shorter in some children. For example; If menstruation is observed in a girl one year after the onset of breast budding, that is, the onset of puberty, this girl's height increase will be less than that of a girl whose menstruation occurs 3 years after breast budding, and therefore her height will remain shorter. The same is true for male adolescents. If puberty is completed early, stature will be shorter than their peers. Determination of the height of the mother and father has an effect. The expected height (target height) of the child when he completes his growth can be calculated from the following formulas;
For boys: (Dad's height + mother's height + 12.5 cm) / 2For girls: (Dad's height - 12.5 cm) + mother's height / 2
Is the height increase in premature and low birth weight babies like those born with normal weight?
One reason for short stature in children is malnutrition in the womb Those born before 37 weeks) can catch up with their peers up to age 4.
How Do Premature Babies Develop Height?
A quarter of children born prematurely (before 37 weeks) or with a birth weight of less than 2500 grams They cannot catch up with their peers until they are 4 years old. Premature and low birth weight babies, who generally cannot catch up with their peers until the age of 4, need support to keep their stature from being short in adolescence and adulthood. important in determining Short stature may be encountered in the later years of life in children who are not of appropriate weight and have nutritional deficiencies in the first 3 years of life. These children cannot catch up with their peers in adolescence.
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