DIFFERENCES IN BONE AGE READINGS BETWEEN PEDIATRIC ENDOCRINOLOGISTS AND RADIOLOGISTS

Objective: Pediatric endocrinologists (PEs) have historically read their own bone age (BA) X-rays based on the belief that radiologists do not accurately interpret these tests. Whether there are significant differences in BA interpretations between these two groups has not been systematically explored. The objectives of the study were to compare BA readings performed by PEs and radiologists and determine whether clinical variables were associated with discrepancies in readings. Methods: A retrospective chart review of children presenting for initial evaluation of short stature (SS) or precocious puberty (PP) who had a BA X-ray completed was performed. Clinical variables analyzed included age, gender, ethnicity, Tanner stage, body mass index, reason for referral, radiologist location (Children's vs. outside hospital), and PE and radiologist BA readings using the Greulich and Pyle method. Results: Of 103 patients aged 9 ± 3.66 years, there was a discrepancy between the PE and radiologist readings on 70 images (68%). Discrepancy ranged from −1.5 to 3.5 years, with a mean of 4 ± 12 months. Patients referred for PP were more likely to have discrepant interpretations than those referred for SS (8.4 months vs. 0.8 months; P = .007). No differences were seen in interpretations between in-house radiologists and those at outside hospitals. Conclusion: Radiologists interpreted BAs differently than PEs in the majority of images. In patients referred for PP, BAs were interpreted as being older by radiologists than by PEs, perhaps due to bias from the reason for referral. Our results provide support for continued independent BA interpretations by PEs. Abbreviations: BA = bone age; GP = Greulich and Pyle; PE = pediatric endocrinologist; PP = precocious puberty; SS = short stature

Dental and bone ages in pediatric patients with chronic renal failure

Objective: To determine the differences between chronological, dental and bone age among pediatric patientswith and without chronic renal failure.Materials and Methods: It was a correlational, comparative and retrospective study. Sixty-six digital radiographsof 33 patients, men and women, aged 7-16 years with chronic renal failure, and 66 digital radiographs of33 patients without chronic renal failure were reviewed. Dental age was determined on panoramic radiographsusing the Demirjian Method and bone age on carpal radiographs using the Greulich and Pyle Method. Descriptiveanalysis was performed and correlation coefficients were calculated with a significance level of 0.05.Results: PA highly significant correlation was observed between the chronological, dental and bone ages inpediatric patients with and without chronic renal failure. Highly significant differences were found in bone ageamong pediatric patients with and without chronic renal failure, as patients with chronic renal failure had 31.6months less than patients without chronic renal failure.Conclusion: Pediatric patients with a diagnosis of chronic renal failure presented delayed bone age in relationto pediatric patients without chronic renal failure

Growth Hormone Deficiency in a Patient with Becker Muscular Dystrophy: A Pediatric Case Report

Objective. To describe a biochemical growth hormone (GH) deficiency and to evaluate therapeutic result in a six-year-old male with Becker muscular dystrophy (BMD).Methods. GH peak was evaluated after response to arginine and insulin. Bone age was evaluated according to Greulich and Pyle method.Results. The GH-supplementary therapy was very effective in terms of growth gain.Conclusion. The possibility of a growth hormone deficiency and treatment with GH in patients with BMD cannot be excluded, especially considering the good therapeutic response.