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X-Ray Bone Age Study

Also known as

Bone Age Assessment

Bone age study is a procedure that enables doctors to determine the maturity of an adolescent's bone system. This procedure comprises taking a single X-ray of the left or right hand, including wrists and fingers. The process is safe and pain-free and uses meager radiation. The X-ray image is compared with X-ray images in a standard guideline of bone development, based on data from many other children of the same gender and age. This process is used to measure a child's bone age, which is measured in years.
A bone age study is used to radiologically determine immature patients' biological and structural maturity from their hand and wrist x-ray appearances. It forms an integral part of the diagnosis, management, and treatment for children with growth and endocrine disorders. It helps diagnose various growth disorders and can predict final height for patients presenting with short stature. An adolescent's bones, such as in the limbs and phalanges, consist of areas of growth called "growth plates." These plates have special cells which handle the bone's length and its development. Growth plates are easily identified on an X-ray because they're softer and composed of lesser minerals than the rest of the bone, making them appear blacker on an X-ray image than the surrounding area. As children age, growth plates change in appearance on the X-ray images and become narrower and slowly disappear. Since they look different at each age, a doctor can assign a bone age based on the growth plates' appearance. A bone age (also known as skeletal age) is given by estimating which of the X-ray images in the atlas guideline most closely match the child's bones' appearance in the X-ray. Differing bone ages and chronological ages might indicate a growth problem. Still, such distinctions don't always mean there's a problem because healthy children can have bone ages that differ from chronological ages. Your pediatrician can also use bone age to monitor children's growth hormone therapy or those presenting in delayed or advanced puberty stages that may need treatment.
Your doctor can use bone age to estimate how long a child will continue to grow when they enter puberty and what their fully grown height will be. Bone age studies can also monitor progress and help in the treatment of kids with growth-affecting conditions, such as growth hormone deficiency, thyroid issues, early or late puberty, glandular disorders, and growth disorders such as Turner syndrome. Bone age assessments are also widely used in pediatric orthodontics, where the child's bone age determines the timing and type of their treatment.
There is no special preparation needed for this procedure. However, do your best to make sure your child is at ease with the x-ray. You should explain to them that there is nothing to be worried about, and it is worth explaining to them how an x-ray machine works in simple terms, such as explaining that it is simply going to be taking a photograph of their bones and will not hurt. You should also explain to them they will have to keep still so that the procedure is complete as soon as possible.
X-ray in a radiology department within a hospital, a radiology center, or a doctor's office. Your child will be required to remove all clothing and jewelry and put on a hospital gown. They may also have to remove glasses and all metal objects from their person. Your child will be asked to enter the x-ray room, which will contain a table, some chairs, and a large X-ray machine. Parents can usually accompany their children to provide support and calm them. If you choose to stay in the room, you'll be asked to wear a lead protective covering to protect your body from the radiation. The x-ray technician will ask your child to sit on a stool and place their left hand on the table with fingers spread (your child may be given a protective lead shield as well). The x-ray technologist will step into an adjoining room to operate the machine. Your child will be asked to remain still for some seconds while the radiograph is taken. This is done to prevent blurring of the X-ray image. Your child may also be asked to breathe in and hold their breath for a few seconds to get the best x-ray image. The bone age assessment is performed with an x-ray image of your child's non-dominant hand, so it is important to mention if your child is left-handed. A single DP view of your child's arm will be taken, including the distal radius and ulna (which are the forearm’s two long bones) and all the fingers. This procedure is only a few minutes from start to finish, and there is no need to worry about radiation exposure since the radiation only lasts a short while. However, developing babies are susceptible to radiation and are at more risk. Thus, if your daughter is pregnant, make sure to tell her doctor and the X-ray technician.
A radiologist (a medical professional specializing in reading and interpreting X-ray images) will interpret the x-rays. They will compare the carpal bones (bones at the base of the hand), finger bones, radius, and ulna to standardized versions in one of two primary medical atlases. Additionally, software tools are available to automate bone age assessment and this may give your x-rays findings much quicker. The comparison will allow the doctor and radiologist to determine your child's bone age and physical maturity. The radiologist will use the findings to prepare a report for your primary physician, who will discuss your x-ray results with you.