Skeletal Maturation


Skeletal Maturation

Table 5.93 Skeletal maturation: accelerated maturation




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.


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




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)



Congenital, total

Involvement of all organ systems.

Congenital, limited

Only muscular, vascular, skeletal, or neurologic involvement.


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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