Laboratory findings of the patient at diagnosis and follow-up 2 months LH (IU/L) 0.48 FSH (IU/L) 1.3 Estradiol (pg/mL) <10 IGF-1 (ng/mL) - Bone age
(years) - Pelvic ultrasonography Uterus: 20 mm BMD - 26 months LH (IU/L) 2.43 FSH (IU/L) 46.67 Estradiol (pg/mL) 10 IGF-1 (ng/mL) 11.7 Bone age
(years) 2 Pelvic ultrasonography Uterus: 16 mm, right ovary: 0.6 mL, left ovary: 0.5 mL BMD - 52 months LH (IU/L) 0.61 FSH (IU/L) 32.8 Estradiol (pg/mL) <10 IGF-1 (ng/mL) 144 Bone age
(years) 3 Pelvic ultrasonography Uterus: 30 mm, right ovary: 0.4 mL, left ovary: could not be detected BMD -1.4 SD LH: luteinizing hormone, FSH: follicle stimulating hormone, IGF-1: insulin-like growth factor-1, BMD: bone mineral density, SD: standard deviation
From the outpatient clinic file records of patients, their weight, height, puberty phase according to Marshall and Tanner (19), basal serum LH, follicle stimulating hormone (FSH), and estradiol studied from venous blood samples taken between 08.00-12.00 after 12-hour fasting, peak serum LH level after exogenous GnRH (gonadorelin 100 [micro]g) intravenous injection, bone age
assessment according to the Greulich and Pyle (20) method, and cranial imaging results were recorded.
The relationship between patients' pubertal status, disease risk category, craniospinal radiotherapy history, BMI, and bone age
with Z-score is shown in Table 1.
We hypothesize that a lower adiposity at start of GH therapy in SGA children and especially in adolescents might induce a lesser degree of adrenal hyperandrogenism and/or compensatory hyperinsulinemia causing less bone age
acceleration [17, 18].
In our survey, surgeons favoured Paley's multiplier method, bone age
estimation, and growth charts.
Caption: Figure 1: Significant osteopenia noted on left hand radiograph and a reduction in bone age
of 1 year based on the metacarpal and phalangeal epiphysis.
Bone maturity was evaluated by the estimation of bone age
(BA), according to Tanner-Whitehouse 3 method (TW3) (Tanner et al.), based on x-ray measurements in 13 bones of the left hand.
FH was assumed when the GV was equivalent to < 2 cm/year, and bone age
was greater than 14 years in females and 16 years in males.
Hypothyroidism for more than one year will decrease bone age
All presented with growth failure, with bone age
1-3 years behind chronological age.
The correlation coefficients for vertebral and hand-wrist bone age
were 0.825 and 0.856 for girls and boys, respectively.
Height, body mass, body mass index (BMI), pubertal stage, bone age
, body composition, BMD and jumping performance were obtained at baseline (T0) and after 3-years (T3).
Rapid growth and bone age
advancement, elevated serum levels of sex steroids, and breast development in girls could all indicate precocious puberty.
Another method used to verify age in young adults is by using radiographs to determine bone age
AAD guidelines recommend laboratory evaluation for younger patients with acne who have clinical signs of androgen excess, such as early onset body odor and axillary and/or pubic hair, accelerated growth, advanced bone age
, or early genital maturation.