title: The use of bone age in clinical practice - part 2.
abstract: If height-limiting treatment is being considered for a child with tall stature, skeletal maturity is invaluable in the selection of appropriate patients for treatment, determining appropriate age of treatment commencement, monitoring progress of treatment, and determining the expected treatment effect on adult height. In precocious puberty, bone maturation can be usefully assessed at initial diagnosis and start of treatment and at regular intervals thereafter during treatment monitoring. Together with height, bone maturation is an essential parameter for long-term treatment monitoring in congenital adrenal hyperplasia. Bone age (BA) determination in children with skeletal dysplasia is only feasible in a few disorders and estimations should be treated with caution. Radiographs of the left hand and wrist are, however, essential in the diagnosis of many skeletal disorders. Bone mineralization and measures of bone lengths, width, thickness and cortical thickness should always be evaluated in relation to a child's height and BA, especially around puberty. The use of skeletal maturity, assessed on a radiograph alone to estimate chronological age for immigration authorities or criminal courts is not recommended.
authors.affiliation: Pediatric Endocrinology and Diabetology, University Children's Hospital, Tübingen, Germany. david.martin@med.uni-tuebingen.de
authors.forename: David D
authors.initials: DD
authors.lastname: Martin
authors.forename: Jan M
authors.initials: JM
authors.lastname: Wit
authors.forename: Ze'ev
authors.initials: Z
authors.lastname: Hochberg
authors.forename: Rick R
authors.initials: RR
authors.lastname: van Rijn
authors.forename: Oliver
authors.initials: O
authors.lastname: Fricke
authors.forename: George
authors.initials: G
authors.lastname: Werther
authors.forename: Noël
authors.initials: N
authors.lastname: Cameron
authors.forename: Thomas
authors.initials: T
authors.lastname: Hertel
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Wudy
authors.forename: Gary
authors.initials: G
authors.lastname: Butler
authors.forename: Hans Henrik
authors.initials: HH
authors.lastname: Thodberg
authors.forename: Gerhard
authors.initials: G
authors.lastname: Binder
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ranke
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy; D000365:Age Determination by Skeleton; D000728:Androgens / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001827:Body Height / Q000187:drug effects; D015519:Bone Density; D001846:Bone Development; D001848:Bone Diseases, Developmental / Q000175:diagnosis; D002113:Calcification, Physiologic; D002648:Child; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011627:Puberty; D011628:Puberty, Delayed / Q000188:drug therapy; D011629:Puberty, Precocious / Q000188:drug therapy; D014505:Urban Population; D014953:Wrist / Q000000981:diagnostic imaging
chemical_list: D000728:Androgens; D047072:Aromatase Inhibitors; D004997:Ethinyl Estradiol