Correlates of the peak height velocity in girls with idiopathic scoliosis.
METHODS
Prospective longitudinal.


OBJECTIVE
Determine correlates of the peak height velocity (PHV) in girls with idiopathic scoliosis.


BACKGROUND
Only identifiable retrospectively, the PHV is the most useful known maturity marker in idiopathic scoliosis. Clinically useful correlates are needed to make PHV timing helpful.


METHODS
A total of 24 immature girls with idiopathic scoliosis were followed with serial heights, sexual staging, skeletal ages, spinal radiographs, insulin-like growth factor (IGF)-1, IGF binding protein-3, dehydroepiandrosterone sulfate, estradiol, bone-specific alkaline phosphatase, and osteocalcin levels. These markers were correlated to PHV timing.


RESULTS
There were 14 girls who had identifiable growth peaks that averaged 10.5 +/- 1.8 cm/y at age 11.7 +/- 1 years. At the PHV, all girls were Risser 0 with open triradiate cartilages. On a skeletal age radiograph, digital uncapped phalangeal epiphyses were indicative of pre-PHV and fused epiphyses of post-PHV. Capped but unfused epiphyses were indeterminate. Tanner stage 1 for breast strongly indicates pre-PHV. Stage 3 for breast and pubic hair occurred at or after the PHV, and stage 4 always occurred after PHV. Higher IGF-1 and estradiol levels after PHV are potentially discriminatory.


CONCLUSIONS
The PHV occurs during Risser 0 with open triradiate cartilages. If triradiate cartilages are open, then Tanner stages, IGF-1, estradiol levels, and the appearance of the epiphyses on a skeletal age radiograph are useful in determining status before or after PHV.
Sanders
James O
JO
Shriners Hospitals for Children, Erie, PA 16505, USA. jsanders@shrinenet.org
Browne
Richard H
RH
Cooney
Timothy E
TE
Finegold
David N
DN
McConnell
Sharon J
SJ
Margraf
Susan A
SA
D015415:Biomarkers / Q000097:blood; D001827:Body Height / Q000502:physiology*; D002648:Child; D018450:Disease Progression; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D011446:Prospective Studies; D012600:Scoliosis / Q000097:blood / Q000503:physiopathology*; D012741:Sexual Maturation / Q000502:physiology; D013131:Spine / Q000254:growth & development*
D015415:Biomarkers; D004958:Estradiol; D007334:Insulin-Like Growth Factor I