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[Reference values of differences between TW3-C RUS and TW3-C Carpal bone ages of children from five cities of China]
Shao-yan Zhang1, Li-juan Liu, Yi-san Han
1Hebei Sports Science Research Institute, Shijiazhuang 050011, China.
Insights
The differences between radius, ulna, and short bones (RUS) and carpal bone age assessments in Chinese children vary with age and sex. These findings offer valuable references for estimating skeletal development in pediatric clinical practice.
Area of Science:
- Pediatric endocrinology and growth disorders.
- Skeletal maturity assessment.
- Radiographic analysis of bone age.
Background:
- Skeletal maturity determination is crucial for diagnosing and monitoring pediatric growth disorders and endocrinological conditions.
- The radius, ulna, and short bones (RUS) and carpal bone age assessments are used, but comparative data for Chinese children are lacking.
- Understanding differences between RUS and carpal bone age can aid in differential diagnosis.
Purpose of the Study:
- To investigate the differences between TW3-Chinese RUS (TW3-C RUS) and TW3-Chinese Carpal (TW3-C Carpal) bone ages in Chinese children.
- To establish reference data for skeletal development estimation in this population.
- To analyze age- and sex-related variations in these differences.
Main Methods:
- A study involving 9408 healthy Han Chinese children (ages 1.5-13.5 years) from five cities.
- Bone age estimation using TW3-C RUS and TW3-C Carpal methods.
- Statistical analysis using Box-Cox power exponential (BCPE) distribution to model Z-score differences and assess goodness-of-fit.
Main Results:
- Mean differences between TW3-C RUS and TW3-C Carpal showed age-specific patterns in boys and girls.
- Standard deviations of the differences varied, generally increasing before age 4.5 (boys) and 4 (girls) and then decreasing.
- The differences were generally greater in boys than in girls, with sex differences diminishing after age 10.
Conclusions:
- The differences between TW3-C RUS and TW3-C Carpal bone ages in Chinese children are age- and sex-dependent.
- Standard deviations of these differences indicate increasing variability in younger children, stabilizing as maturity approaches.
- The study provides Z-score curves and charts as references for clinical application in skeletal development assessment.
Objective:
The determination of skeletal maturity has an important role in pediatric clinical practice, especially in relation to endocrinological problems and growth disorders, and it is frequently useful in diagnosis and monitoring treatment. It has been suggested that the difference between radius, ulna and short bonse (RUS) and carpal may be of differential diagnostic significance. However, no data on comparison among bone ages of Chinese children are available. The differences between TW3-Chinese RUS (TW3-C RUS) and TW3-Chinese Carpal (TW3-C Carpal) bone age of Chinese children were observed in this study to provide references for skeletal development estimation.
Methods:
Totally 9408 Han healthy children (5066 boys, 4302 girls) aged 1.5 - 13.5 years from 5 cities of China were enrolled in this study. The bone ages of the children were estimated by TW3-C RUS and TW3-C Carpal. The Z score curves of the differences between them were fitted by BCPE distribution and the goodness-of-fit of Box-Cox power exponential distribution (BCPE) models were assessed by Q-test and percents of cases of sample below the fitted percentile curves.
Results:
The means of the differences between TW3-C RUS and TW3-C Carpal were -0.19 - 0.17 over the age 2.0 - 13.5 years in boys and -0.12 - 0.13 from age 1.5 - 11.5 years in girls. The standard deviations were respectively 0.47 - 1.01 years for boys and 0.49 - 0.82 years for girls. The degrees of freedom, with respect to the parameter curves from BCPE distribution, were selected and the percentile curves were fitted by BCPE. The differences between percents of cases below the fitted percentile curves and expected values were all under 0.66%, exception of difference for 90th percentile in girls.
Conclusions:
The differences between TW3-C RUS and TW3-C Carpal varied with age, the standard deviations increased gradually before 4.5 years of age in boys and 4 years of age in girls, and afterwards the variations decreased steadily until the TW3-C Carpal has reached full maturity. However, there was sex diversity in the extent of the variations. The differences between TW3-C RUS and TW3-C Carpal for boys were evidently greater than that for girls. The sex difference decreased progressively after 10 years. The proposed Z scores curves charts should provide reference for clinical practice.
