Amenorrhea x ray: Difference between revisions
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{{CMG}}; {{AE}} | {{CMG}}; {{AE}} | ||
==Overview== | ==Overview== | ||
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| [[Image:Delayed-bone-age.jpg|250px|thumbnail|16 years old girl with growth hormone insufficiency, Case courtesy of Dr Aneta Kecler-Pietrzyk, <ref name=Delayed puberty"https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/53554">rID: 53554</ref>]] | |||
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There are no [[X-ray]] findings associated with amenorrhea. | There are no [[X-ray]] findings associated with amenorrhea. | ||
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==X Ray== | ==X Ray== | ||
*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]]. | ||
** Studies have shown that there is strong association between [[bone age]] and the initiation of [[puberty]] in boys involved in [[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> | |||
** The researches suggested that skeletal [[maturation]] and [[hypothalamus]]-[[pituitary]]-[[gonadal]] axis [[maturation]] rates are relevant to each other. Delayed [[puberty]] is related to the skeletal [[maturation]] delay, that can be caused by various diseases, such as [[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>, [[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>, [[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>, [[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>, and [[Growth hormone|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]] have to be studied. 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> | |||
** If the difference between measured [[bone age]] and chronological age is more than 2 years, it will strongly diagnostic of [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]]. | |||
** If the [[bone age]] shows the 4 years delay, it may reflect a 8 cm more final adult height in patient. Final adult height can be concluded 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> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 20:44, 28 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
 <ref> tag |
There are no X-ray findings associated with amenorrhea.
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.
- Studies have shown that there is strong association between bone age and the initiation of puberty in boys involved in developmental disorders.[1][2]
- The researches suggested that skeletal maturation and hypothalamus-pituitary-gonadal axis maturation rates are relevant to each other. Delayed puberty is related to the skeletal maturation delay, that can be caused by various diseases, such as chronic diseases[3], malnutrition[4], hypothyroidism[5], constitutional delay of growth[6], and growth hormone (GH) deficiency[7].
- For measuring bone age by means of X-ray, the left hand and wrist have to be studied. 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 will strongly diagnostic of constitutional delay of growth and puberty (CDGP).
- If the bone age shows the 4 years delay, it may reflect a 8 cm more final adult height in patient. Final adult height can be concluded 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.