Amenorrhea x ray: Difference between revisions
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==X Ray== | ==X Ray== | ||
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| [[Image:Delayed-bone-age.jpg|250px|thumbnail|16 years old girl with growth hormone insufficiency | | [[Image:Delayed-bone-age.jpg|250px|thumbnail|16 years old girl with growth hormone insufficiency - Case courtesy of Dr Aneta Kecler-Pietrzyk, via Radiopaedia.org<ref name=Delayed puberty"https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/53554">rID: 53554<nowiki></ref>]] | ||
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* There are no [[X-ray]] findings associated with amenorrhea exclusively. | * There are no [[X-ray]] findings associated with amenorrhea exclusively. | ||
* There are no [[X-ray]] findings associated with most common causes of amenorrhea, like [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] and [[premature ovarian failure]]. | * There are no [[X-ray]] findings associated with most common causes of amenorrhea, like [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] and [[premature ovarian failure]]. | ||
* However, an [[X-ray]] may be helpful in the diagnosis of [[delayed puberty]]. | * However, an [[X-ray]] may be helpful in the diagnosis of [[delayed puberty]]. | ||
** | ** A strong association is found between [[bone age]] and the onset of [[puberty]] in boys with [[developmental disorders]].<ref name="pmid14715856">{{cite journal |vauthors=Flor-Cisneros A, Leschek EW, Merke DP, Barnes KM, Coco M, Cutler GB, Baron J |title=In boys with abnormal developmental tempo, maturation of the skeleton and the hypothalamic-pituitary-gonadal axis remains synchronous |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=1 |pages=236–41 |year=2004 |pmid=14715856 |doi=10.1210/jc.2002-021954 |url=}}</ref><ref name="pmid16837127">{{cite journal| author=Flor-Cisneros A, Roemmich JN, Rogol AD, Baron J| title=Bone age and onset of puberty in normal boys. | journal=Mol Cell Endocrinol | year= 2006 | volume= 254-255 | issue= | pages= 202-6 | pmid=16837127 | doi=10.1016/j.mce.2006.04.008 | pmc=1586226 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16837127 }}</ref> | ||
** | ** Skeletal [[maturation]] and [[hypothalamus]]-[[pituitary]]-[[gonadal]] axis [[maturation]] rates are related to each other. Delayed [[puberty]] is related to the skeletal [[maturation]] delay, that can be caused by various conditions include: | ||
** For measuring [[bone age]] by means of [[X-ray]], the left hand and [[wrist]] | *** [[Chronic diseases]]<ref name="pmid7113957">{{cite journal |vauthors=Kulin HE, Bwibo N, Mutie D, Santner SJ |title=The effect of chronic childhood malnutrition on pubertal growth and development |journal=Am. J. Clin. Nutr. |volume=36 |issue=3 |pages=527–36 |year=1982 |pmid=7113957 |doi= |url=}}</ref> | ||
** If the difference between measured [[bone age]] and chronological age is more than 2 years, it is | *** [[Malnutrition]]<ref name="pmid3083790">{{cite journal |vauthors=Alvear J, Artaza C, Vial M, Guerrero S, Muzzo S |title=Physical growth and bone age of survivors of protein energy malnutrition |journal=Arch. Dis. Child. |volume=61 |issue=3 |pages=257–62 |year=1986 |pmid=3083790 |pmc=1777696 |doi= |url=}}</ref> | ||
** The [[metaphysis]] of the patients with delayed puberty usually takes | *** [[Hypothyroidism]]<ref name="pmid1863095">{{cite journal |vauthors=Pantsiouou S, Stanhope R, Uruena M, Preece MA, Grant DB |title=Growth prognosis and growth after menarche in primary hypothyroidism |journal=Arch. Dis. Child. |volume=66 |issue=7 |pages=838–40 |year=1991 |pmid=1863095 |pmc=1793266 |doi= |url=}}</ref> | ||
<br> | *** [[Constitutional delay of puberty|Constitutional delay of growth]]<ref name="pmid11932291">{{cite journal |vauthors=Sedlmeyer IL, Palmert MR |title=Delayed puberty: analysis of a large case series from an academic center |journal=J. Clin. Endocrinol. Metab. |volume=87 |issue=4 |pages=1613–20 |year=2002 |pmid=11932291 |doi=10.1210/jcem.87.4.8395 |url=}}</ref> | ||
*** [[Growth hormone deficiency|Growth hormone (GH) deficiency]]<ref name="pmid170299">{{cite journal |vauthors=Tanner JM, Whitehouse RH |title=A note on the bone age at which patients with true isolated growth hormone deficiency enter puberty |journal=J. Clin. Endocrinol. Metab. |volume=41 |issue=4 |pages=788–90 |year=1975 |pmid=170299 |doi=10.1210/jcem-41-4-788 |url=}}</ref> | |||
** For measuring [[bone age]] by means of [[X-ray]], the left hand and [[wrist]] should be used. Greulich and Pyle Atlas may be used to interpret the findings.<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref><ref name="pmid24772153">{{cite journal| author=Manzoor Mughal A, Hassan N, Ahmed A| title=The applicability of the Greulich & Pyle Atlas for bone age assessment in primary school-going children of Karachi, Pakistan. | journal=Pak J Med Sci | year= 2014 | volume= 30 | issue= 2 | pages= 409-11 | pmid=24772153 | doi= | pmc=3999020 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24772153 }}</ref> | |||
<br> | ** If the difference between measured [[bone age]] and chronological age is more than 2 years, it is diagnostic of [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]]. | ||
** The [[metaphysis]] of the patients with delayed puberty usually takes longer duration to mature when compared to the normal population. Thus, final adult height in patients of delayed puberty is slightly more than the final adult height of a normal individual. If the [[bone age]] shows a difference of ≥ 4 years, it may reflect an additional increase of 8 cm in the final adult height of the patient with delayed puberty. Final adult height can be calculated through Bayley-Pinneau tables.<ref name="pmid11836292">{{cite journal |vauthors=Wit JM, Rekers-Mombarg LT |title=Final height gain by GH therapy in children with idiopathic short stature is dose dependent |journal=J. Clin. Endocrinol. Metab. |volume=87 |issue=2 |pages=604–11 |year=2002 |pmid=11836292 |doi=10.1210/jcem.87.2.8225 |url=}}</ref><ref name="pmid14918032">{{cite journal |vauthors=BAYLEY N, PINNEAU SR |title=Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards |journal=J. Pediatr. |volume=40 |issue=4 |pages=423–41 |year=1952 |pmid=14918032 |doi= |url=}}</ref> | |||
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==References== | ==References== | ||
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[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Gynecology]] | |||
[[Category:Obstetrics]] | |||
[[Category:Radiology]] | |||
Latest revision as of 20:23, 29 July 2020
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Amenorrhea Microchapters |
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Amenorrhea x ray On the Web |
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American Roentgen Ray Society Images of Amenorrhea x ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
There are no specific X-ray findings associated with amenorrhea. There are no X-ray findings associated with most common causes of amenorrhea, like polycystic ovary syndrome (PCOS) and premature ovarian failure. However, an X-ray may be helpful in the diagnosis of delayed puberty.
X Ray
 |
- There are no X-ray findings associated with amenorrhea exclusively.
- There are no X-ray findings associated with most common causes of amenorrhea, like polycystic ovary syndrome (PCOS) and premature ovarian failure.
- However, an X-ray may be helpful in the diagnosis of delayed puberty.
- A strong association is found between bone age and the onset of puberty in boys with developmental disorders.[1][2]
- Skeletal maturation and hypothalamus-pituitary-gonadal axis maturation rates are related to each other. Delayed puberty is related to the skeletal maturation delay, that can be caused by various conditions include:
- For measuring bone age by means of X-ray, the left hand and wrist should be used. Greulich and Pyle Atlas may be used to interpret the findings.[8][9]
- If the difference between measured bone age and chronological age is more than 2 years, it is diagnostic of constitutional delay of growth and puberty (CDGP).
- The metaphysis of the patients with delayed puberty usually takes longer duration to mature when compared to the normal population. Thus, final adult height in patients of delayed puberty is slightly more than the final adult height of a normal individual. If the bone age shows a difference of ≥ 4 years, it may reflect an additional increase of 8 cm in the final adult height of the patient with delayed puberty. Final adult height can be calculated through Bayley-Pinneau tables.[10][11]
References
- ↑ Flor-Cisneros A, Leschek EW, Merke DP, Barnes KM, Coco M, Cutler GB, Baron J (2004). "In boys with abnormal developmental tempo, maturation of the skeleton and the hypothalamic-pituitary-gonadal axis remains synchronous". J. Clin. Endocrinol. Metab. 89 (1): 236–41. doi:10.1210/jc.2002-021954. PMID 14715856.
- ↑ Flor-Cisneros A, Roemmich JN, Rogol AD, Baron J (2006). "Bone age and onset of puberty in normal boys". Mol Cell Endocrinol. 254-255: 202–6. doi:10.1016/j.mce.2006.04.008. PMC 1586226. PMID 16837127.
- ↑ Kulin HE, Bwibo N, Mutie D, Santner SJ (1982). "The effect of chronic childhood malnutrition on pubertal growth and development". Am. J. Clin. Nutr. 36 (3): 527–36. PMID 7113957.
- ↑ Alvear J, Artaza C, Vial M, Guerrero S, Muzzo S (1986). "Physical growth and bone age of survivors of protein energy malnutrition". Arch. Dis. Child. 61 (3): 257–62. PMC 1777696. PMID 3083790.
- ↑ Pantsiouou S, Stanhope R, Uruena M, Preece MA, Grant DB (1991). "Growth prognosis and growth after menarche in primary hypothyroidism". Arch. Dis. Child. 66 (7): 838–40. PMC 1793266. PMID 1863095.
- ↑ Sedlmeyer IL, Palmert MR (2002). "Delayed puberty: analysis of a large case series from an academic center". J. Clin. Endocrinol. Metab. 87 (4): 1613–20. doi:10.1210/jcem.87.4.8395. PMID 11932291.
- ↑ Tanner JM, Whitehouse RH (1975). "A note on the bone age at which patients with true isolated growth hormone deficiency enter puberty". J. Clin. Endocrinol. Metab. 41 (4): 788–90. doi:10.1210/jcem-41-4-788. PMID 170299.
- ↑ Palmert, Mark R.; Dunkel, Leo (2012). "Delayed Puberty". New England Journal of Medicine. 366 (5): 443–453. doi:10.1056/NEJMcp1109290. ISSN 0028-4793.
- ↑ Manzoor Mughal A, Hassan N, Ahmed A (2014). "The applicability of the Greulich & Pyle Atlas for bone age assessment in primary school-going children of Karachi, Pakistan". Pak J Med Sci. 30 (2): 409–11. PMC 3999020. PMID 24772153.
- ↑ Wit JM, Rekers-Mombarg LT (2002). "Final height gain by GH therapy in children with idiopathic short stature is dose dependent". J. Clin. Endocrinol. Metab. 87 (2): 604–11. doi:10.1210/jcem.87.2.8225. PMID 11836292.
- ↑ BAYLEY N, PINNEAU SR (1952). "Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards". J. Pediatr. 40 (4): 423–41. PMID 14918032.