Daneff Monica, Casalis Claudia, Bruno Claudio H, Bruno Didier A
Fundación Científica del Sur, Buenos Aires, Argentina.
Pediatr Radiol. 2015 Jul;45(7):1007-15. doi: 10.1007/s00247-014-3253-0. Epub 2015 Jan 9.
Radiographic bone age determination is part of the routine evaluation of suspected growth disorders. Simplicity and low cost are its major advantages, but although the effective dose of ionizing radiation is low, it should be taken into consideration given its cumulative effect.
To assess the chronological ultrasonographic emergence of the ossification centers of the hand and wrist.
Cross-sectional study of healthy patients ages 1 to 24 months (n=498) from Buenos Aires, Argentina. All patients underwent ultrasonographic evaluation of the left hand and wrist to identify the different bone nuclei; a subgroup of infants had their nuclei measured (n=228).
Girls showed an earlier emergence of the evaluated nuclei and a trend to a greater size than age-matched boys. Size-for-age relation showed linear increase. Carpal bones (capitate and hamate) were the first to appear, as early as from the first 3 months of life, an age gap not thoroughly present on the radiographic atlas developed by Greulich and Pyle. The distal epiphysis of the radius and the second metacarpophalangeal joint (index finger) followed in order of emergence. The proximal epiphysis of the first metacarpal bone (thumb) was the last to emerge and was infrequently found on boys at age 24 months. Overall, these findings are in accordance with the radiographic atlas. An ultrasonography atlas of the left hand and wrist was outlined for girls and boys.
Conventional ultrasonography allows proper identification of the ossification centers of the hand and wrist and may become an innocuous follow-up tool for patients with growth disorders.
影像学骨龄测定是疑似生长障碍常规评估的一部分。其主要优点是操作简单且成本低，不过尽管电离辐射的有效剂量较低，但鉴于其累积效应仍应予以考虑。
评估手和腕部骨化中心的实际超声出现时间。
对来自阿根廷布宜诺斯艾利斯的498名1至24个月健康患儿进行横断面研究。所有患儿均接受左手和腕部的超声检查以识别不同的骨核；对其中一组婴儿的骨核进行了测量（n = 228）。
女孩的被评估骨核出现时间更早，且与年龄匹配的男孩相比有更大的趋势。年龄与大小的关系呈线性增加。腕骨（头状骨和钩骨）最早出现，早在出生后的前3个月，这一在Greulich和Pyle编制的放射影像学图谱中未充分体现的年龄差异就已出现。桡骨远端骨骺和第二掌指关节（食指）按出现顺序随后出现。第一掌骨（拇指）近端骨骺最后出现，在24个月大的男孩中很少见到。总体而言，这些发现与放射影像学图谱一致。为女孩和男孩勾勒了左手和腕部的超声图谱。
传统超声检查能够准确识别手和腕部的骨化中心，可能成为生长障碍患者无害的随访工具。
