Disturbances of bone growth and development.
"What is growth anyway? Can one talk about positive growth in childhood, neutral growth in maturity, and negative growth in old age?" Our goal is to help promote normal positive growth in infants and children. To achieve this, we must be cognizant of the morphologic changes of both normal and abnormal bone formation as they are reflected in the radiographic image of the skeleton. The knowledge of the various causes and the pathophysiologic mechanisms of the disturbances of bone growth and development allows us to recognize the early radiographic manifestations. Endocrine and metabolic disorders affect the whole skeleton, but the early changes are best seen in the distal ends of the femurs, where growth rate is most rapid. In skeletal infections and in some vascular injuries two-or three-phase bone scintigraphy supercedes radiography early in the course of the disease. MRI has proved to be very helpful in the early detection of avascular bone necrosis, osteomyelitis, and tumor. Some benign bone tumors and many bone dysplasias have distinct and diagnostic radiographic findings that may preclude further studies. In constitutional diseases of bone, including chromosomal aberrations, skeletal surveys of the patient and all family members together with biochemical and cytogenetic studies are essential for both diagnosis and genetic counseling. Our role is to perform the least invasive and most informative diagnostic imaging modalities that corroborate the biochemical and histologic findings to establish the definitive diagnosis. Unrecognized, misdiagnosed, or improperly treated disturbance of bone growth can result in permanent deformity usually associated with disability.
Ledesma-Medina
J
J
University of Pittsburgh School of Medicine, Pennsylvania.
Newman
B
B
Oh
K S
KS
D001848:Bone Diseases, Developmental / Q000000981:diagnostic imaging*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000293:injuries / Q000528:radiation effects; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007855:Lead Poisoning / Q000000981:diagnostic imaging; D007938:Leukemia / Q000000981:diagnostic imaging; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D011859:Radiography