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KMID : 0648420090140010045
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Journal of Korean Society of Pediatric Endocrinology
2009 Volume.14 No. 1 p.45 ~ p.51
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Clinical Significance of Cone-shaped Epiphysis and Brachymesophalangia of the Fifth Middle Phalanx in Korean Children with Normal Short Stature
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Jung Yun-Hye
Yoo Jae-Ho
Choi Im-Jeong
Hong Su-Young
Choi Eun-Jeong
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Abstract
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Purpose: The cone-shaped epiphyses mid-5 (CSE-5) and brachymesophalagia-5 (BMP-5) are common osseous anomalies. Those are thought to be normal variants. We evaluated the frequency of CSE-5 and BMP-5 and the influence of them on adult height in Korean children with normal short stature.
Methods: We retrospectively reviewed medical records of 322 normal short stature children. Lengths of the fourth (MP-4) and fifth middle phalanx (MP-5) and widths of MP-5 of all children were measured. Two indicies for BMP-5 were used. Index 1 was based upon the ratio of the width to the length of the MP-5. Index 2 was based upon the ratio of the lengths of MP-5 to MP-4. CSE-5 was assessed by visual inspection only. We assessed several clinical parameters as follows; advanced skeletal maturation, z-scores of height, target height (THz) and predicted adult height (PAHz) according to CSE-5 and/or BMP-5.
Results: Of the 322 children, 23.6% had BMP-5 (male 19.5%, female 27.4%), 23.6% had CSE-5 (male 13.0%, female 33.3%). The children with CSE-5 and/or BMP-5 were more advanced skeletal maturation than normal fifth finger (0.07±1.09 yrs vs -0.23±1.34 yrs, P=0.049), lower PAHz (-1.13±1.09 vs -0.71±1.28, P=0.008), lower PAHz- THz (-0.53±1.07 vs -0.14±1.30, P=0.013). In male subjects, the PAHz had weak correlation with index 1 (r=-0.26, P=0.001) and index 2 (r=0.27, P=0.001).
Conclusion: This study suggests that BMP-5 and CSE-5 in Korean children with short stature are one contributable factor for adult height.
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KEYWORD
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Bone development, Dysplasia, Phalanges of fingers, Hand radiography, Body height
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