Metacarpal Growth During Adolescence in a Longitudinal South African Cohort

To monitor the drift of the periosteal and endocortical surfaces during metacarpal growth longitudinally, radiogrammetry was carried out on hand-wrist X-rays of 572 children from the Birth to Twenty Bone Health Cohort annually from ages 9 to 21 years. This is the largest collection of longitudinal X-rays in African children. The second metacarpal bone length, bone width, and medullary width were measured using digital vernier calipers on a total of 4730 X-rays. Superimposition by Translation and Rotation (SITAR) was used to obtain age at peak metacarpal length velocity (PLV). Bone width and medullary width were modeled using SITAR against both chronological age and age from PLV. In black and white females, tempo and velocity of metacarpal length growth was synchronized. Black males, however, attained PLV 7 months later than white males (p < 0.0001). Compared to white males, black males had a longer second metacarpal (p < 0.05), and greater bone width size (p < 0.02), tempo (p < 0.0009), and velocity (p < 0.0001). Medullary width growth velocity in black participants peaked 2 years prior to attainment of PLV and exceeded that of their white peers (p < 0.0001) in whom it peaked 6 to 12 months post-PLV attainment. Black adolescents therefore had wider bones with relatively thinner cortices and wider medullary cavities than their white peers. Ethnic and sex differences also occurred in the timing of medullary width contraction that accompanied expansion in bone width and cortical thickness. In black males, medullary width contraction commenced approximately 3 years later than in black females, whereas in white males this occurred a year later than in white females. The ethnic and sex differences in bone acquisition reported in this study may differentially affect bone mass in later life. © 2017 American Society for Bone and Mineral Research.