Metacarpal thickness, width, length and medullary diameter in children--reference curves from the First Zürich Longitudinal Study.
CONCLUSIONS
Metacarpal thickness (T), width (W), length (L) and medullary diameter (M) were measured in 3,121 X-rays from 231 healthy Caucasian children aged 3 to 19 years and analysed for bone age, age, height, weight and gender-related characteristics, showing highly differentiated growth patterns with prepubertal dips. Reference data for the four metacarpal measures are presented.


BACKGROUND
The aim of the study was to create and explore a reference database for metacarpal T, W, L and M in children.


METHODS
Three thousand one hundred twenty-one left-hand X-rays (1,661 from boys) from 231 healthy Caucasian subjects (119 boys) aged 3 to 19 years were analysed by BoneXpert, a programme for automatic analysis of hand X-rays and bone age (BA; in years).


RESULTS
In boys, growth of T, W and L shows a prepubertal decrease from BA 7 to 13 and then accelerates again. In girls, the same is seen only for T starting from BA 8 to 11, whereas W and L grow at a declining rate. M shows steady growth until BA 10.5 in girls and BA 13.5 in boys and then grows smaller in both. W is greater in boys from BA 6 onwards, while L is greater in girls from BA 9 to 13 and T from BA 11 to 14. BA is reflected best by L until start of puberty and by T and L thereafter.


CONCLUSIONS
T, W, L and M show highly differentiated growth patterns. These reference data provide a basis for further research into skeletal development and the management of hormone therapies in children.
Pediatric Endocrinology and Diabetology, University Children's Hospital, Hoppe-Seyler Strasse 1, 72076 Tübingen, Germany. david.martin@med.uni-tuebingen.de
D D
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Martin
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Heckmann
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Jenni
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Ranke
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Binder
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Thodberg
D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods; D000375:Aging / Q000473:pathology / Q000502:physiology; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D050279:Metacarpal Bones / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000254:growth & development*; D012016:Reference Values; D012727:Sex Characteristics; D055815:Young Adult