ANother response to the bone-age q

[Guest guest]

Hi--Here is an email I got in response to my question about bone-age.

-Katy

Katy,

I had asked the same questions you had on bone age delay and still don't know

a whole lot about it. Brad had similar measurments as . At age 3 and 6

months, he was 2 years and 8 months - a 10 month delay. My pedi at the time

said, oh that is just constitutional growth delay - not too much delayed.

But it kept bugging me because it seemed big enough to see a pedi endo along

with the other symptoms. I asked for the referral and his endo still said

that it was probably CGD but wanted to stim test him anyway. He was GHD to

her suprise. She said that he was right at 2 Standard deviations on bone age

delay - enough to warrant a possible problem with his growth hormone. I was

told for his age and I'm sure s that the rule of thumb is every 5 months

is a standard deviation and to be covered by insurance, they need to be at

least 2 S.D. on bone age delay. Of course, if they are GHD anyway, the endo

could have that particular criteria waived.

I would say 8 months delay at his age is close to being significant for GHD.

My endo said with GHT the bone age should catch up to chronological age and a

bone age should be done annually. I was also told bone age could be caused

by malnutrition, thyroid deficiency and Constitutional Growth Delay. Also,

she said bone age is usually more delayed in GHD children than with CGD or

malnutrition. But if one just started to become GHD (it was caught early

enough) then the bone age delay would be less significant.