Related Experiment Video
Updated: May 12, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Paraphyseal changes on bone-age studies predict risk of delayed radiation-associated skeletal complications following
Mary T Kitazono Hammell1, Nancy Bunin, J Christopher Edgar
1Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA19104, USA. mkitazono@gmail.com
Insights
Children receiving total body irradiation (TBI) may show bone changes on bone-age studies. These paraphyseal changes predict future skeletal complications, with severity correlating to risk.
Area of Science:
- Pediatric oncology
- Radiology
- Skeletal biology
Background:
- Children undergoing total body irradiation (TBI) are at risk for delayed skeletal complications.
- Bone-age studies in these children can reveal subtle paraphyseal changes, including physeal widening, metaphyseal irregularity, and paraphyseal exostoses.
Purpose of the Study:
- To determine if paraphyseal changes on bone-age studies following TBI indicate a predisposition to other radiation-associated skeletal complications.
- Investigate the correlation between the severity of paraphyseal changes and the development of subsequent skeletal issues.
Main Methods:
- Retrospective review of medical records and bone-age studies for 77 children who received TBI.
- Grading of bone-age studies based on the severity of paraphyseal changes.
- Statistical analysis using Kendall's tau-b to assess the association between paraphyseal changes and skeletal complications.
Main Results:
- Significant positive association found between physeal widening, metaphyseal irregularity/sclerosis, and paraphyseal exostoses with delayed skeletal complications.
- Children with moderate paraphyseal changes had a 58% complication rate, while those with severe changes had a 90% rate, compared to 30% with no/mild changes.
Conclusions:
- Paraphyseal changes identified on bone-age studies are positively correlated with the development of delayed skeletal complications after TBI.
- Bone-age assessments can help identify children at higher risk for radiation-induced skeletal damage.
Background:
Children undergoing total body irradiation (TBI) often develop delayed skeletal complications. Bone-age studies in these children often reveal subtle paraphyseal changes including physeal widening, metaphyseal irregularity and paraphyseal exostoses.
Objective:
To investigate whether paraphyseal changes on a bone-age study following TBI indicate a predisposition toward developing other radiation-associated skeletal complications.
Materials And Methods:
We retrospectively reviewed medical records and bone-age studies of 77 children receiving TBI at our institution between 1995 and 2008 who had at least 2 years of clinical follow-up and one bone-age study after TBI. We graded bone-age studies according to the severity of paraphyseal changes. All documented skeletal complications following TBI were tabulated. Kendall's tau-b was used to examine associations between degree of paraphyseal change and development of a skeletal complication.
Results:
Kendall's tau analyses showed that physeal widening and metaphyseal irregularity/sclerosis (tau = 0.87, P < 0.001) and paraphyseal exostoses (tau = 0.68, P < 0.001) seen on bone-age studies were significantly positively associated with the development of delayed skeletal complications following TBI. Thirty percent of children with no or mild paraphyseal changes developed a delayed skeletal complication, compared with 58% of children with moderate paraphyseal changes and 90% of children with severe paraphyseal changes.
Conclusion:
Paraphyseal changes identified on a bone-age study correlate positively with the development of delayed skeletal complications elsewhere in the skeleton following TBI.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:19The Effect of Aging on Tissues
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion