Skeletal Maturation



10.1055/b-0034-87946

Skeletal Maturation





























Table 5.93 Skeletal maturation: accelerated maturation

Diagnosis


Comments


Endocrine


Comparison with an atlas of normal maturation will show the acceleration. Prolonged elevation in sex steroids. DD: precocious puberty and congenital adrenal hyperplasia, premature adrenarche, obesity, hyperthyroidism, lipodystrophy, gonadotropin-producing tumors.


Idiopathic



Beckwith-Wiedemann syndrome


Exomphalos, macroglossia, and gigantism in the neonate. Increased risk of developing adrenal carcinoma, nephroblastoma, hepatoblastoma, and rhabdomyosarcoma.


Sotos syndrome


Acromegalic features. Mental retardation. Although growth may be rapid in first years and bone age advanced, final height may not be excessive.


Marshall-Smith syndrome


Failure to thrive, mental retardation, blue sclera, and unusual facies with large forehead, shallow orbits, and depressed nasal bridge.


Polyostotic fibrous dysplasia (McCune-Albright syndrome)


(see Table 5.31 )

































Table 5.94 Skeletal maturation: delayed maturation

Diagnosis


Findings


Comments


Abnormal endocrine function


Comparison with an atlas of normal maturation will show the delay.


Global delay in maturation. DD: growth hormone deficiency, hypothyroidism, Addison disease, Cushing disease, craniopharyngioma, psychosocial dwarfism.


Chronic illness




Severe malnutrition




Chromosomal abnormalities




Skeletal dysplasias with epiphyseal involvement


(see Table 5.33 )


Trisomy 18 and 21, Turner syndrome.





























Table 5.95 Skeletal maturation: classification of asymmetric maturation (hemihypertrophy)

Diagnosis


Comments


Congenital, total


Involvement of all organ systems.


Congenital, limited


Only muscular, vascular, skeletal, or neurologic involvement.


Acquired


Localized hyperemia.


Associated with a syndrome


Neurofibromatosis and Beckwith-Wiedemann (approximately 13% of patients), Klippel-Trénaunay-Weber, Proteus, McCune-Albright, and many other syndromes.


Tumors associated with hemihypertrophy


DD: Wilms tumor, adrenal carcinoma, rhabdomyosarcoma, and hepatoblastoma.62


Macrodystrophia lipomatosa


Fig. 5.44, p. 525


Fig. 5.45, p. 525


Progressive overgrowth of all the mesenchymal elements with a disproportionate increase in the fibroadi-pose tissues.63

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Jul 12, 2020 | Posted by in PEDIATRIC IMAGING | Comments Off on Skeletal Maturation

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