Metacarpal index in short stature before and during growth hormone treatment
a Division of
Paediatric Endocrinology, Children's Hospital, University of
Heidelberg, 69120 Heidelberg, Germany, b Department of Neonatology, University
of Heidelberg, c Department of
Paediatric Radiology, University of Heidelberg
Correspondence to: Dr Markus Bettendorf, Kinderklinik, Pädiatrische Endokrinologie, Universität Heidelberg, Im Neuenheimer Feld 150, 69120 Heidelberg, Germany. e-mail: markus_bettendorf{at}ukl.krz.uni-heidelberg.de
Accepted 24 February
1998
AIMS
To assess the
usefulness of the metacarpal index (MCI) as a radiographic measure of
the proportions of the metacarpals in the differential diagnosis of
short stature. To investigate the significance of the MCI in following
the longitudinal growth and proportions of individual long bones during
growth hormone stimulated catch up growth in children with short
stature with and without growth hormone deficiency.
SUBJECTS124 children,
including 65 children with short stature caused by growth hormone
deficiency, 13 with familial short stature, 29 with idiopathic short
stature, and 17 with Ullrich-Turner syndrome.
METHODSRetrospective
analysis of the MCI in five posterior-anterior radiographs of the left
hand of all patients, which were performed sequentially for routine
bone age determinations (Greulich and Pyle) before and during the first
three years of growth hormone treatment.
RESULTSThe MCI was
similar in all patient groups, resembled that of healthy children, and
correlated significantly with chronological age, bone age, and height
before and during growth hormone treatment. Despite a remarkable growth
hormone stimulated catch up growth, the MCI did not change
significantly during growth hormone treatment.
CONCLUSIONSThe role
of the MCI is insignificant in the diagnosis of short stature, but the
MCI can serve as an auxological measure of osseous proportions during
longitudinal growth. Growth hormone treatment accelerates longitudinal
growth without affecting the proportions of the long bones, indicating
that growth hormone stimulated bone growth closely resembles
spontaneous bone growth.
© 1998 by Archives of Disease in Childhood
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