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Pediatric Radiology

- See:
        - Methods to Etimate Growth Potenital: 
        - Growth Plate Anatomy 

- Appearance of Ossification Centers:
    - skeleton incompletely ossified at birth, & portions such as carpals, patella, navicular, cuneiforms, will radiographically appear entirely cartilaginous;
    - ossification centers will enlarge in all directions, until it becomes bounded on metaphyseal side by the epiphyseal plate and on all other sides by articular cartilage;
           - at this point, the nuceus grows only on the sides adjacent to cartilage;
    - primary ossification centers at 8 weeks gestation in both radius and ulna
    - secondary ossification centers arise between birth and the 20th year;
          - fusions of these secondary centers w/ main bones usually occur in late adolescence;
          - specific ossification centers make their appearance in a specific order: 
                - ossification centers in calcaneus and talus appear in the sixth to eighth fetal month (or earlier); 
                - distal femoral epiphysis & proximal tibial epiphysis is present at birth; 
                - cuboid appears at the time of or soon after birth; 
                - proximal femoral epiphysis appears between 2 - 8 months following birth; 
                - distal epiphyses of radius appears radiographically at age 1 - often from two centers 
                - ossification center of the greater trochanter appears at 2 yrs and fuses to metaphysis at 16 years;
                - radial head epiphysis is not present until after 3 years of age (may occur between 5-7 years); 
                - distal ulnar epiphysis appears at age 5;
                - ossific nucleus of the pisiform appears at about 6 to 8 years of age
                - olecranon appears between 9-10 years;

               

- Chronologic Age by Risser's Sign:
    - Girls                                Boys
    - Risser      Age            Risser     Age
          1         13.8               1        15.2
          2         14.3               2        15.2
          3         14.7               3        16.3
          4         16.0               4        16.3
          5         16.1               5        18.0

- Approximate Contributions to Growth: (until age 13 for females and age 15 for males)
      - proximal femur   = 1/8  in./year
      - distal femur        = 3/8  in./year
      - proximal tibia     = 1/4  in./year
      - distal tibia          = 3/16 in./year
      - total adult ht       = ht. at age 2 x 2
      - growth ceases: 15 - 15 1/2 yrs for girls, 17 - 17 1/2 yrs for boys


 - hand of a 10 year old male;



Accuracy of the Sauvegrain Method in Determining Skeletal Age During Puberty.