ESPE Abstracts (2018) 89 RFC11.6

Reference Values of Automated Bone Age and Bone Health Index for Mexican Children and Adolescents

América Liliana Miranda Lora, Montserrat Espinosa Espíndola, Desireé López González, Mariana Sánchez-Curiel Loyo, Pilar Dies Suárez & Miguel Klünder Klünder


Hospital Infantil de México Federico Gómez, Mexico city, Mexico


Background: BoneXpert is a software for automated measurement of bone age (BA) and radiogrammetry (bone health index). The precision error of the software for BA measure is smaller than the human rating error and the accuracy relative to the human routine ratings is 0.80 years. Differences in skeletal maturation between ethnicities have been reported, so it is important to have specific references for the own population.

Objective: To present the automated BA reference curves and bone health index for Mexican children and adolescents.

Methods: We conducted a cross-sectional study. We included 722 children Mexico City’s metropolitn area (5 to 18 years old). A hand AP radiography was taken and analyzed using BoneXpert software to determine automated BA and bone health index. We constructed the reference values curves for BA and bone health index.

Results: We observed a BA similar to Greulich and Pyle scale up to age 10 and then approximately 0.9 years ahead at the end of puberty (Table 1). On the other hand, an increase in the bone health index was observed according to the increase in skeletal maturation; however, the values at the end of puberty are lower than that reported in other populations (mean 5.5±0.46 in boys and mean 5.3± in girls).

Table 1 Automated BA minus age
BoysGirls
Age (y)MeanStd. Dev.n MeanStd. Dev.n
5−0.150.5615−0.600.9220
6−0.760.70230.310.7619
7−0.770.9153−0.231.1215
8−0.301.3846−0.671.0917
9−0.381.61410.361.1730
100.031.62280.061.1925
110.181.0326−0.111.4026
12−0.131.32301.101.3022
130.371.37200.771.1824
140.651.36230.870.6131
150.911.26410.660.9326
160.611.01260.380.6530
170.440.7620−0.420.5318
18−0.310.7914−1.220.304

Conclusions: Mexican children have an acceleration in BA that causes an advance of about 1 year at the end of puberty. This could have an effect on the lowest final adult height observed in the Mexican population in comparison with other populations. Additionally, the bone health index in Mexican children is lower than other populations at the end of puberty. Future studies are required to evaluate the clinical implications of this observation.

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