Âge osseux, intérêt diagnostique et limites

C. Adamsbaum (Professeur des Universités, praticien hospitalier), C. André (praticien hospitalier), V. Merzoug (praticien hospitalier), G. Kalifa (Professeur des Universités, praticien hospitalier)
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Abstract

Bone age represents only one factor of the child development and needs to be included in the whole physical and biological context. Short statures are more frequent than gigantism. Presently, the diagnostic strategy for a short stature is partially based on imaging analysis: cerebral imaging can disclose a tumour in case of Gh deficiency (mainly craniopharyngioma) or median line and/or pituitary malformations; skeletal imaging seeks for abnormalities that may suggest bone dysplasia. The main indications of bone age evaluation are a discrepancy between civil age and stature, and less frequently the follow-up of chronic diseases. The bone age is routinely estimated from an X-ray of the left wrist and hand in case of growth abnormality over one year of age (Greulich and Pyle method).

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骨年龄,诊断兴趣和局限性
骨龄只是儿童发育的一个因素,需要纳入整个生理和生物环境。矮个子比巨人症更常见。目前,身材矮小的诊断策略部分是基于影像学分析:在Gh缺乏(主要是颅咽管瘤)或中线和/或垂体畸形的情况下,脑部影像学可以发现肿瘤;骨骼成像寻找可能提示骨发育不良的异常。骨龄评估的主要指征是年龄与身高的差异,慢性病的随访较少。在一岁以上生长异常的情况下,通常通过左手腕和手的x线片来估计骨龄(Greulich和Pyle法)。
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