Discordance between knee and hand-wrist bone age in adolescents: implications for skeletal maturity assessment and its association with thyroid-stimulating hormone levels.

IF 2.3 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-09-02 DOI:10.1007/s00247-025-06363-7

Yuxin Sun, Zhibo Zhou, Xueqing Zheng, Hanze Du, Fengdan Wang, Shi Chen, Hui Pan

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引用次数: 0

Abstract

Background: Hand-wrist radiographs may not fully reflect skeletal bone age (BA) during mid-to-late puberty. Knee magnetic resonance imaging (MRI), a non-radiative imaging technique, may provide detailed evaluation of the lower limbs.

Objective: To validate the San Diego MRI-based knee BA atlas in a Chinese adolescent cohort presenting with growth deceleration, evaluate the concordance between knee and hand-wrist BA, and explore factors influencing potential discrepancies.

Materials and methods: This study involved 227 adolescents. Hand-wrist BA was assessed using the Greulich and Pyle atlas with hand-wrist radiographs, and knee BA using the San Diego atlas with knee MRI. Correlations between knee BA, hand-wrist BA, and chronological age (CA) were analyzed. Discrepancies between the two sites were further evaluated for associated clinical factors.

Results: Knee BA correlated better with CA (r_s = 0.816, P < 0.001) than with hand-wrist BA (r_s = 0.763, P < 0.001). The mean difference between hand-wrist BA and CA was 1.08 ± 1.19 years, and between knee BA and CA was 0.71 ± 1.06 years (P < 0.001). 14.1% of adolescents showed more advanced knee maturity than hand-wrist bones. Thyroid-stimulating hormone (TSH) levels were positively associated with the difference between hand-wrist and knee BA (r_s = -0.198, P = 0.011). Subclinical hypothyroidism significantly increased the risk of knee overmaturity (OR = 6.022, P < 0.001).

Conclusion: Knee MRI is a reliable imaging modality for assessing skeletal maturity in adolescents with growth retardation. A moderate correlation was observed between hand-wrist and knee BA. In adolescents with elevated TSH levels, knee MRI may be preferable to hand-wrist radiographs for predicting final height, evaluating growth potential, and guiding growth hormone therapy decisions.

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青少年膝关节和手腕骨年龄的不一致：骨骼成熟度评估的意义及其与促甲状腺激素水平的关系。

背景：在青春期中后期，手腕x线片可能不能完全反映骨骼骨龄（BA）。膝关节磁共振成像（MRI）是一种非放射性成像技术，可以提供下肢的详细评估。目的：验证基于圣地亚哥mri的膝关节BA图谱在中国青少年生长减速队列中的有效性，评估膝关节和腕关节BA之间的一致性，并探讨影响潜在差异的因素。材料与方法：本研究涉及227名青少年。采用Greulich和Pyle寰图结合腕部x线片评估了手腕部BA，采用San Diego寰图结合膝关节MRI评估膝关节BA。分析膝关节BA、手腕BA与实足年龄（CA）之间的相关性。进一步评估两个部位之间的差异以寻找相关的临床因素。结果：膝关节BA与CA相关性较好（rs = 0.816, P s = 0.763, P s = -0.198, P = 0.011）。结论：膝关节MRI是评估发育迟缓青少年骨骼成熟度的一种可靠的成像方式。手-腕-膝BA有中度相关性。在TSH水平升高的青少年中，在预测最终身高、评估生长潜力和指导生长激素治疗决策方面，膝关节MRI可能比手腕x线片更可取。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.