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Percent Final Height Is a Novel Method That Identifies Differences Between the Rate of Development in American
Tristen N Taylor1,2, Ally A Yang3, Tiffany M Lee2
1Department of Orthopaedic Surgery, Texas Children's Hospital, Houston, TX.
Journal of Pediatric Orthopedics
|June 28, 2024
Summary
Skeletal development varies by race, with Black and Hispanic children showing advanced bone age (BA) compared to Caucasian children. These findings highlight the need for race-specific growth assessments, moving beyond older standards.
Area of Science:
- Pediatric Endocrinology
- Skeletal Development
- Radiographic Assessment
Background:
- The Greulich & Pyle (G&P) atlas, based on 1926-1942 Caucasian hand X-rays, is a historical standard for skeletal development.
- Modern pediatric populations exhibit diverse ancestries, necessitating updated skeletal development assessments.
- This study investigates skeletal development patterns across different racial groups as a function of percent final height (PFH).
Purpose of the Study:
- To compare bone age (BA) and chronological age (CA) across modern Caucasian, Black, Hispanic, and Asian children.
- To analyze skeletal maturation differences as a function of percent final height (PFH) across racial groups.
- To identify potential race-based variations in skeletal development using contemporary data.
Main Methods:
- Retrospective review of hand X-rays and height measurements from 498 children (53 Asian, 83 Black, 190 Hispanic, 172 White).
- Calculation of percent final height (PFH) and comparison of bone age (BA) and chronological age (CA) between races.
- Polynomial regression modeling of PFH against CA and BA; comparison of mean ages at 85th PFH; analysis by Sanders stages.
Main Results:
- Black and Hispanic children demonstrated significantly advanced bone age (BA) compared to White children (P <0.001).
- At 85th PFH, Black males and Hispanic females reached this stage at younger ages than White counterparts.
- Hispanic and Black males showed greater BA than White males at 85th PFH; Asian females also showed advanced BA compared to Black females.
Conclusions:
- Bone age (BA) significantly exceeds chronological age (CA) by over a year in Black and Hispanic children.
- Race-specific variations in skeletal maturation are evident, particularly at the 85th percentile of final height.
- Current findings suggest the need for race-adjusted skeletal development assessments and potentially revised growth atlases.
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