Manzoor Mughal Arsalan, Hassan Nuzhat, Ahmed Anwar
Dr. Arsalan Manzoor Mughal, MBBS, M. Phil Candidate, Senior Lecturer, Department of Anatomy, Ziauddin University, Karachi, Pakistan.
Dr. Nuzhat Hassan, MBBS, M.Phil (Anatomy), Professor & Head of Anatomy Department, Ziauddin University, Karachi, Pakistan.
Pak J Med Sci. 2014 Jan;30(1):211-5. doi: 10.12669/pjms.301.4295.
The bone age of a child indicates his/her level of biological and structural maturity better than the chronological age calculated from the date of birth. Radiography of the hand & wrist is the commonest modality used to calculate bone age. Automated methods for evaluation of hand and wrist radiographs are also being developed which reduce inter rater variability compared to manual methods. Non radiation based techniques of visualizing hand & wrist bones such as ultrasonography for bone age calculation have been theorized but are not as accurate as radiographic methods. By the age of 18 years, bone age cannot be computed from hand & wrist radiographs, therefore the medial end of the clavicle is used for bone age calculation in individuals aged 18-22 years. CT visualization of the clavicle has been extensively studied but requires a high dose of radiation. MRI based methods are being developed but require more research. Dental age is an alternate form of bone age determination, which also gives an estimate of skeletal maturity. The iliac bone and femoral head have also been studied for computation of bone age but no standardized methods have yet been generated. As different modalities of bone age estimation provide different results and their applicability differs in different ethnicities, we need to design studies in order to compare them and select the method best suited to Pakistani children. Sources of Data/Study Selection: Recent articles published between years 2004-2013 obtained from online search engines Pubmed and Google Scholar were used in preparation of this review.
儿童的骨龄比根据出生日期计算的实际年龄更能体现其生物和结构成熟水平。手部和腕部的X线摄影是计算骨龄最常用的方法。目前也在开发用于评估手部和腕部X线片的自动化方法，与手工方法相比，这种方法减少了评估者之间的差异。理论上也有一些基于非辐射技术来观察手部和腕部骨骼，比如用超声检查来计算骨龄，但这些方法不如X线摄影方法准确。到18岁时，就无法通过手部和腕部X线片来计算骨龄了，因此对于18 - 22岁的个体，锁骨内侧端被用于骨龄计算。对锁骨的CT可视化已经进行了广泛研究，但需要高剂量辐射。基于MRI的方法也在开发中，但还需要更多研究。牙齿年龄是骨龄测定的另一种形式，也能对骨骼成熟度进行估计。也有人研究了利用髂骨和股骨头来计算骨龄，但尚未形成标准化方法。由于不同的骨龄估计方法得出的结果不同，且它们在不同种族中的适用性也不同，我们需要设计研究来比较它们，并选择最适合巴基斯坦儿童的方法。数据来源/研究选择：本综述使用了从在线搜索引擎PubMed和谷歌学术搜索中获取的2004 - 2013年间发表的近期文章。
