Note: This research was supported by CTSI's Pediatric Clinical Research Center, one of eight clinical sites in the Bay Area managed by the Clinical Research Services program.
By Juliana Bunim, from UCSF.edu
Measuring bone age should be a standard practice of care for pediatric patients with Crohn’s disease, in order to properly interpret growth status and improve treatment, according to a new study from the UCSF Benioff Children’s Hospital.
“Not only is bone age helpful in predicting a child’s remaining growth potential, our study demonstrates that bone age is necessary to correctly interpret a patient’s growth status in pediatric Crohn’s disease,” said lead study researcher Neera Gupta, MD, MAS, a pediatric gastroenterologist at the UCSF Benioff Children’s Hospital.
Impaired growth and delayed puberty are common complications in children with Crohn’s disease, with up to 80 percent of patients showing compromised growth. Typically, growth is interpreted based on a patient’s chronological age, and growth status is one of the key factors driving therapeutic decisions.
In the study, researchers measured bone age with a left hand/wrist x-ray in 49 pediatric patients with Crohn’s disease whose ages ranged from five to 17 years-old. Bone age is a measure of skeletal maturity, and, as a people grow, their bones change in shape and size. Based on the appearance of the bones and growth plates on the X-ray, a doctor can determine the bone age. Results can be given as a Z- score, either as average which is zero, or as a number of standard deviations above or below zero, taking into account the sex and chronological age of the patient. High bone age is defined as having a bone age Z- score (BA-Z score) > 2, and low bone age is defined as a BA-Z score < -2.
The study, “Determination of Bone Age in Pediatric Patients with Crohn’s Disease Should be Part of Routine Care,” is currently online in the journal Inflammatory Bowel Diseases.