Bone age may be affected by several factors, including gender, nutrition, as well as metabolic, genetic, and social factors and either acute or chronic diseases, including endocrine dysfunction ( 3– 9).Īpplications in Medical Field: Role of Delayed and Advanced Bone Ageīy evaluating the data obtained from bone age in the clinical setting, it is possible to distinguish three main groups of subjects: patients with delayed bone age, patients with bone age appropriate to chronological age, and patients with advanced bone age ( 3, 8– 10).Ĭonstitutional delay of growth and puberty is one of the most common causes of delayed bone age ( 10). This determination is based on the presence of particular centers of bone formation as well as the dimension and structure of the bones ( 3, 5– 8). Therefore, chronological age differs from bone age, so the two indexes need to be distinguished: chronological age is defined as the age in years between birth and the evaluation of a subject bone age is defined by the age expressed in years that corresponds to the level of maturation of bones. Many of these parameters, and particularly growth spurt and menarche, correlate better with bone age compared to chronological age ( 4). During growth, biological maturity is defined by several parameters, including the characterization of skeletal maturity, sexual maturity, dental elements eruption, menarche, spermarche, deepening of the voice, growth spurt, and the achievement of 95% of the adult height ( 1– 3). This information, associated with the characterization of the shape and changes of bones, represents an important factor of the biological maturation process. The images obtained by hand and wrist X-ray reflect the maturity of different bones. Nowadays, many methods are available to evaluate bone age. Hand and wrist X-rays are considered as an important indicator of children's biological age. Therefore, the complete characterization of the main methods and procedure available and particularly of all their advantages and disadvantages need to be known in order to properly utilized this information for all its medical and non-medical main fields of application.Įvaluation of skeletal maturity is a common procedure frequently performed in clinical practice. As well several differences can be characterized according to the numerous standardized methods developed over the past decades. Bone age may be affected by several factors, including gender, nutrition, as well as metabolic, genetic, and social factors and either acute and chronic pathologies especially hormone alteration. This information, associated to the characterization of the shape and changes of bone components configuration, represent an important factor of the biological maturation process of a subject. In fact, the images obtained by hand and wrist X-ray reflect the maturity of different types of bones of the skeletal segment evaluated. Although several bones have been studied to better define bone age, the hand and wrist X-rays are the most used images.

It is defined by the age expressed in years that corresponds to the level of maturation of bones. Our findings do not support the hypothesis that skeletal maturation directly influences the age of pubertal onset in normal boys.Bone age represents a common index utilized in pediatric radiology and endocrinology departments worldwide for the definition of skeletal maturity for medical and non-medical purpose. Similarly, there was not a significant correlation between pubertal advancement and height age advancement, weight age advancement, or BMI age advancement. In addition, there was no significant correlation between skeletal advancement and pubertal advancement ( r = 0.01, P = 0.9). The variability in bone age at onset of puberty was not less than the variability in chronological age. Pubertal onset was defined by serum testosterone ≥30 ng/dL. Height, weight, and serum testosterone concentrations were assessed every 6 months and bone age (Fels method) every year. To determine whether this concordance is also present in normal children, we analyzed data from 30 normal boys participating in a longitudinal study. Many conditions that delay skeletal maturation also delay the onset of puberty, whereas conditions that accelerate skeletal maturation often hasten the onset puberty, raising the possibility that skeletal maturation influences pubertal onset.

Bone age less than chronological age