By John H. Juhl MD, Andrew B. Crummy MD, Janet E. Kuhlman MD
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Example text
Conditions such as thyrotoxicosis, sexual precocity, and even simple exogenous obesity advance bone age. 5 This method is particularly helpful for patients older than 2 years of age. The accuracy of this method for the American population is such that its use as the sole method of assessment is sufficient in most instances. 3 ,6 ,8 The age is based on the presence or absence of ossification centers and their configurations (Figs. 1-6 and 1-7 ). The accuracy of this method can be enhanced by attention to detail.
The maturity of an individual should not be confused with the size or height of an individual. The relative degree of depression or acceleration of skeletal maturation is compared with the present height to predict the ultimate height. If skeletal maturation is advanced and the present height is normal, the individual will ultimately be small. If maturation is retarded and the present height is normal, the individual will ultimately be taller than normal. 5 ,12 The standards have been based largely on the growth of normal children whose heights fall within a relatively restricted range on either side of normal or mean stature.
B: Axillary view demonstrates the impaction fracture of the humeral head (arrow) and posterior displacement of the humeral head in relation to the posterior rim of the glenoid (arrowhead). An asterisk marks the lateral margin of the clavicle. FIG. 2-47. Axial magnetic resonance images of the left shoulders of two different patients with history of previous glenohumeral dislocations. A: Previous anterior dislocation, now reduced. Note Hill-Sachs defect (arrow) in characteristic location, posterolateral aspect of humeral head.