Fusion of the medial clavicular epiphysis in the South African and Kenyan populations / Fusión de la epífisis clavicular medial en las poblaciones de Sudáfrica y Kenia

Age estimation from clavicular ossification has been studied by many researchers based on the pattern and degree of the epiphyseal union through the use of dry bone specimens, radiographs, CT and MRI. These studies found clavicular ossification as a useful age indicator up to the third decade of life. The study aimed to document any population specific influence on age estimation using fusion processes of the clavicular epiphysis between the South African and Kenyan population groups. To achieve this objective a study of one thousand six hundred and five (n=1605) digital radiographs of South African and Kenyan population groups, aged between 14-30 years, were evaluated. The ossification process of the medial clavicular epiphysis was scored against Schmeling's staging system. Growth variations between the two cohorts were carried out using student t-test analysis to assess for any significant differences between the means and standard deviations of the cohorts. A log linear regression test was also applied to test bilateral asymmetry in the ossification status for the medial epiphysis. The results of the paired linear model indicated a wide gap between chronological age (CA) and estimated age (EA) in patients under 20 years. The regression tests observed no significant difference between the EA of the South African and Kenyan populations. The current study yielded no significant differences in the ossification process of the medial clavicle amongst the Black South African and Kenyan populations when using Schmeling's staging system.

La estimación de la edad a partir de la osificación clavicular ha sido estudiada por muchos investigadores según el patrón y el grado de unión epifisaria mediante el uso de muestras de hueso seco, radiografías, tomografía computarizada y resonancia magnética. Estos estudios encontraron la osificación clavicular como un indicador de edad útil hasta la tercera década de la vida. El estudio tuvo como objetivo documentar cualquier influencia específica de la población en la estimación de la edad utilizando los procesos de fusión de la epífisis clavicular entre los grupos de población de Sudáfrica y Kenia. Para lograr este objetivo, se evaluó un estudio de mil seiscientas cinco (n = 1605) radiografías digitales de grupos de la población de Sudáfrica y Kenia, con edades comprendidas entre 14 y 30 años. El proceso de osificación de la epífisis clavicular medial se puntuó frente al sistema de estadificación de Schmeling. Las variaciones de crecimiento entre las dos cohortes se llevaron a cabo utilizando la prueba t de Student para evaluar las diferencias significativas entre las medias y las desviaciones estándar de las cohortes. También se aplicó una prueba de regresión lineal para evaluar la asimetría bilateral en el estado de osificación de la epífisis medial. Los resultados del modelo lineal indicaron una gran brecha entre la edad cronológica (CA) y la edad estimada (EA) en pacientes menores de 20 años. En las pruebas de regresión no se observaron diferencias significativas entre la EA de las poblaciones de Sudáfrica y Kenia. El presente estudio no presentó diferencias significativas en el proceso de osificación epífisis medial de la clavícula entre las poblaciones negras de Sudáfrica y Kenia cuando se usó el sistema de estadificación de Schmeling et al.

Lexema phy-sis en terminologia anatomica / Lexema phy-sis in terminologia anatomica

Múltiples palabras habituales utilizan raíces grecolatinas, como el caso de las estructuras mencionadas en Terminologia Anatomica. Un grupo de términos anatómicos originados en la Antigua Grecia emplean el lexema griego phy-sis o su homólogo ­fisis en español, es por ello que este trabajo tiene por objetivo analizar su significado y etimología en el diccionario de la Universidad de Salamanca, Diccionario de Términos Médicos de la Real Academia Nacional de Medicina y en el Diccionario Etimológico griego-latín del español, para contribuir a la comprensión y aprendizaje de Terminologia Anatomica en el estudio de la Anatomía Humana. Se propone que los estudiantes que cursan la asignatura de Anatomía Humana posean conocimientos básicos de latín y griego, para facilitar su aprendizaje y correcta aplicación de los términos.

Multiple common words use Greek and Latin roots, as is the case of structures mentioned in Terminologia Anatomica. For instance, a number of anatomical terms originating in ancient Greece, use the Greek lexeme ph-sis or its homologue -fisis in Spanish. Therefore, this work aims to analyze meaning and etymology of this term in the Universidad de Salamanca dictionary, the Royal National Academy of Medicine Dictionary of Medical Terms, and in the Spanish etymological Greek-Latin dictionary, to contribute to the understanding and learning of Terminologia Anatomica in the study of Human Anatomy. To facilitate learning and the correct use of Terminologia Anatomica, we propose that students in Human Anatomy course assignments acquire a basic knowledge of Latin and Greek.

Age estimation from ossification of the medial clavicular epiphysis by computed tomography / Estimación de la edad de osificación de la epífisis medial clavicular por tomografía computadorizada

The current study intended to evaluate the accuracy of age estimation from the development of the medial clavicular epiphysis (sternal end of the clavicle) in Egyptian population using computed tomography (CT) and to develop a discriminant formula that can be used in Egyptians. The study was conducted on 142 subjects (84 males and 58 females) after taken informed consent. They were subjected to multi-slice CT on the medial end of clavicles of both sides. The results revealed that the age of non - union was seen at 8­17 years; incomplete union at 15­20 years and complete union was seen at 20 years. It is concluded that the ossification of medial clavicular end could be used for age estimation. Also CT is a good visualization tool to be used. Regression analysis for each and both clavicles in both sexes is specific to Egyptian population and should be used after validation of the results in other ones. The study recommended using stage 1 to be <17 years; stage 2 to be >15 years; Stage 3 to be >15 years; stage 4 of maturation to be >19 years and stage 5 to be >21 years.

El objetivo de esta investigación fue evaluar en la población egipcia, la exactitud de estimación de edad del desarrollo de la extremidad esternal de la clavícula, mediante tomografía computadorizada (TC), y desarrollar una fórmula discriminante que se pueda utilizar en egipcios. La investigación se realizó en 142 pacientes (84 hombres y 58 mujeres) después de obtener el consentimiento informado. Los pacientes fueron sometidos a TC de cortes múltiples en la extremidad esternal de la clavícula en ambos lados. Los resultados revelaron que la no unión fue observada entre los 8­17 años; la unión incompleta entre 15­20 años y la unión completa a los 20 años. Se concluye que la osificación de la extremidad esternal de la clavícula podría ser utilizada para la estimación de la edad utilizando la TC como herramienta de visualización. El análisis de regresión para ambas clavículas en los dos sexos es específico de la población egipcia y se debe utilizar después de validar los resultados. El estudio recomienda el uso de la etapa 1 en <17 años, etapa 2 en >15 años, etapa 3 en >15 años, etapa 4 en la maduración >19 años y la etapa 5 >21 años.

Proximal femoral epiphysis: manual morphometry versus digital morphometry / Epífisis femoral proximal: morfometría manual versus morfometría digital

It is important and necessary to know the morphometric characteristics of the proximal femur in order to reduce the risk of complications associated with surgical procedures performed in the area due to vascular, metabolic or trauma causes, and to achieve an alignment of prosthesis to be implanted. The morphometric analysis has proved possible to be used, and can be a valid help to obtain certain parameters that may contribute to scientific research in several areas. For this, a good understanding of evaluation techniques and principles that can be applied to obtain reliable and valid results is needed. To measure the proximal femoral epiphysis by manual morphometry, with the aid of the caliper, and digital morphometry, with the aid of software and compare them. Twenty nine femurs were used to measure the following parameters: diameter of the femoral head in the cranio caudal axis (DFH­CC) and sagittal axis (DFH­S), diameter of the femoral neck cranio caudal axis (DFN­CC) and sagittal axis (DFN­S), length of the femoral neck (LFN) and length of the intertrochanteric line (LIL). After the measurements, the mean values were compared between the two morphometric techniques. The manual morphometry obtained the following average values: DFH­CC 4.42±0.44, DFH­S 4.38±0.47; DFN­CC 3.10±0.35; DFN­S 2.50±0.37; LFN 2.55±0.42; LIL 4.79±0.62. While the values obtained by digital morphometry were: DFH­CC 3.09±0.41, DFH­S 3.35±0.40; DFN­CC 1.79±0.26; DFN­S 2.26±0.23; LFN 1.42±0.33; LIL 3.33±0.54. All parameters measured from the manual technique showed values significantly higher (p<0.05) than values obtained by digital morphometry. This study showed that there is no morphometry gold standard. Different morphometric methods can effectively reproduce, the values of morphometric anatomical structures, depending on the purpose of the study, the anatomical structures and experience of the researcher.

Es importante y necesario conocer las características morfométricas del fémur proximal con el fin de reducir el riesgo de complicaciones asociadas con los procedimientos quirúrgicos realizados en la zona debido a causas vasculares, metabólicas o traumáticas y para lograr una alineación de prótesis para ser implantada. El análisis morfométrico ha demostrado que es posible utilizar, y puede ser una ayuda válida para obtener ciertos parámetros que pueden contribuir a la investigación científica en diversas áreas. Para ello, se necesita un buen conocimiento de las técnicas de evaluación y los principios que se pueden aplicar para obtener resultos fiables y válidos. El objetivo fue medir la epífisis femoral proximal mediante morfometría manual mediante la ayuda de pinza y compararla con la morfometría digital mediante software . Veintinueve fémures fueron utilizados para medir los siguientes parámetros: diámetro de la cabeza femoral en el eje cráneo-caudal (DFH­CC) y eje sagital (DFH-S), diámetro del eje cráneo-caudal del cuello femoral (DFN­CC) y eje sagital (DFN­S), longitud del cuello femoral (LFN) y la longitud de la línea intertrocantérica (LIL). Después de las mediciones, los valores medios se compararon entre las dos técnicas morfométricas. La morfometría manual obtuvo los siguientes valores medios: DFH­CC 4,42±0,44, DFH­S 4,38±0,47; DFN­CC 3.10±0.35; DFN­S 2,50±0,37; LFN­2,55±0,42; LIL 4,79±0,62. Mientras que los valores obtenidos por la morfometría digitales fueron: DFH­CC 3,09±0,41, DFH­S 3,35±0,40; DFN­CC 1,79±0,26; DFN­S 2,26±0,23; LFN 1,42±0,33; LIL 3,33±0,54. Todos los parámetros medidos de la técnica manual mostraron valores significativamente mayores (p<0,05) que los valores obtenidos por morfometría digital. Este estudio mostró que no existe un estándar en morfometría. Diferentes métodos morfométricos pueden reproducir de manera efectiva los valores de las estructuras anatómicas morfométricas, dependiendo del propósito del estudio, de las estructuras anatómicas y la experiencia del investigador.

Age determination from pelvis A radiological study in Mumbai region.

The bones of human skeletons develop from separate ossification centers. From these centers ossification progresses till the bone is completely formed. These changes can be studied by means of X-rays and these changes are age related. It is therefore possible to determine the approximate age of an individual by radiological examination of bones till ossification is complete. This radiological study was carried out with the objective to assess the general skeletal maturity around crest of ilium and ischial tuberosity, of subjects in Mumbai region. 99 males between age group of 9-25 years and 76 females between age group of 3-23 years attending the outpatient department of this hospital were selected. Age confirmed from history and noting the birth dates from driving license, passport, rations card or voter’s card. The cases were selected after ruling out the nutritional, developmental, and endocrinal abnormality which affects the skeletal growth. Data analysis was done in P4 computer using HPSS software. At the end conclusions were drawn which are compared with available results of various previous studies

Proximal femoral epiphysis anatomy in chilean population: orthopedic and forensic aspects / Anatomía del epífisis proximal del fémur en la población chilena. Aspectos traumatológicos y forenses

From a biomechanical standpoint, bone geometry and density are factors correlated to the bone resistance of the femur when supporting body weight, with geometric parameters like the diameter of the femoral head and neck, the length of the femoral neck, and the femoral neck angle as determinant factors in the incidence of hip fractures, which increase in frequency and seriousness in osteoporotic patients. In Chile, morphometric data that contributes to relating the anatomy of the proximal epiphysis of the femur as an associated factor in hip fractures does not exist; likewise, there are no anthropometric indexes that may contribute to the forensic sciences. The purpose of this study is to establish average measurements of the proximal epiphysis of the femur in the adult Chilean population. Descriptive Study. The proximal epiphyses of 81 dry adult femurs were analyzed (44 right and 37 left bones), measuring the following parameters: length of the femoral neck (LN), femoral neck angle (FNA), circumference of the femoral head (CH) and circumference of the femoral neck (CN). The statistical relationship between the measurements and the side of each sample was analyzed (t-test p=0.05). The average lengths were LN= 3.59cm (+/- 0.43 cm); FNA= 124.17 (+/- 6.37), CH= 14.34 cm (+/- 1.27 cm) and CN= 9.7 cm (+/- 0.87 cm). No significant differences between the left and right sides were found. Average numbers were obtained for the anatomy of the proximal femoral epiphysis from a sample in the Chilean population. With the data obtained, we propose to carry out anatomo-clinical, epidemiologic and forensic studies in this population.

Desde un punto de vista biomecánico, la geometría y la densidad ósea son factores correlacionados con la resistencia del hueso del fémur al apoyar el peso corporal, con los parámetros geométricos, como el diámetro de la cabeza femoral y el cuello, la longitud del cuello del fémur, y el ángulo del cuello femoral factores determinantes en la incidencia de fracturas de cadera, que aumentan en frecuencia y gravedad en los pacientes con osteoporosis. En Chile, no existen datos morfométricos que relacionen la anatomía de la epífisis proximal del fémur como un factor asociado a las fracturas de cadera ni índices antropométricos que pueden contribuir a las ciencias forenses. El propósito de este estudio es establecer las medidas promedio de la epífisis proximal de fémur en población adulta chilena. Estudio Descriptivo. Se analizaron la epífisis proximal de 81 fémures adultos secos (44 derechos y 37 izquierdos), midiendo los siguientes parámetros: longitud del cuello femoral (LC) , ángulo cérvico-diafisiario femoral (ACD), circunferencia de la cabeza femoral (CCa) y circunferencia del cuello femoral (CCu). Se analizó la relación estadística de las medidas con el lado de cada muestra (test Chi cuadrado p:0,05) Las longitudes promedios fueron LC: 3,59 cm (+/- 0,43 cm); ACD: 124,17 (+/- 6,37 cm); CCa: 14,34 cm (+/- 1,27 cm) y CCu: 9,7 cm (+/- 0,87 cm). No se encontraron diferencias significativas entre el lado derecho e izquierdo. Los resultados proponen la necesidad de realizar estudios anatomo-clínicos y epidemiológicos actualizados en población chilena donde la geometría de la epífisis proximal del fémur se incluya dentro del análisis.

Age Determination from Clavicle A Radiological Study in Mumbai Region.

The bones of human skeletons develop from separate ossification centres. From these centers ossification progresses till the bone is completely formed. These changes can be studied by means of X-rays and these changes are age related. It is therefore possible to determine the approximate age of an individual by radiological examination of bones till ossification is complete. This radiological study was carried out with the objective to assess the general skeletal maturity around Medial end of clavicle, of subjects in Mumbai region. 131 males between age group of 9-25 years and 68 females between age group of 3-23 years attending the outpatient department of this hospital were selected. Age confirmed from history and noting the birth dates from driving license, passport, rations card or voter‘s card. The cases were selected after ruling out the nutritional, developmental, and endocrinal abnormality which affects the skeletal growth. Data analysis was done in P4 computer using HPSS software. At the end conclusions were drawn which are compared with available results of various previous studies.

A review of the chronology of epiphyseal union in the bones at knee and ankle joint.

Determination of the age of an individual from the appearance and the fusion of the ossification centres is a well accepted fact in the field of medical and legal professions. The process of formation of bones is called as “ossification”. Ossification of bone is a diagnostic tool for estimation of age until the process is complete for the particular bone. The long bones of lower limb play a vital role in assessment of age both in living and dry remains. Many scientists have tried to conclude there observations on bones of lower limb owing to differences in regional and environmental factors. Countable differences are noticed in the appearance and fusion activities of ossification centers depending on race geographic distribution and sex. Following is a review of works carried out so far in different regions of country as well as throughout the world.

Original research paper radiological study of disappearance of tri-radiate cartilage in pelvic-bone in Gujarati population.

For medico-legal purposes evidence of age is very essential in various types of cases such as Identification, Consent, Rape, Attainment of Majority, and Eligibility for Employment, etc. Various work done on the study of age determination by the study of appearance of ossification centers and epiphyseal union of different bones in India as well as abroad indicate a reasonable variation. Majority of them conclude that, the ossification and epiphyseal union of a bone vary in different part of the world. To the best of our knowledge very little work has been done on the study of disappearance of tri-radiate cartilage out of various bony parts useful for age estimation. The present study comprising of 50 subjects ( male=35; female=15),was carried out during the period January 2000 to July 2001 at the Forensic Medicine department and Department of radiology, B.J. Medical College, Ahmedabad.

Computed tomographic studies on ossification status of medial epiphysis of clavicle: Effect of slice thickness and dose distribution.

The accuracy of technique adopted for Forensic age diagnostics of young adults and adolescents especially in case of livings lies in the standardization of the technical parameters used. The emerging radiological techniques, when used in standardized way may minimize the possibilities of misinterpretation, as it has been practically shown in present study. CT scans of 100 live subjects were performed on 16-slice (Siemen’s Sensation 16) CT scan machine and the volumetric data acquired was reconstructed into five separate sets of slice thickness for each one of the subjects included in the study and the ossification status for each set of slice thickness was determined for all the subjects separately. The results are almost identical while evaluating ossification stages from 1 and 2 mm thick slice data but the differences are found in the ossification stages when evaluated using 3 mm, 5 mm and 7 mm slice thickness as compared those found in 1 and 2 mm slice thickness. It was concluded that by increasing slice thickness the rate of error-nous interpretation are also increasing. Thus, the minimum reliable thickness to produce high resolution scans in order to get maximum accuracy is 2 mm for staging medial clavicular ossification from CT scan and the reconstruction should be done using kernel (filter) B60F at window setting osteo (1500/450HU).

Age estimation from medial end of clavicle by x- ray examination.

Fixing up of the individuality of a person, no matter if it is new born baby in the hospital or in criminal cases and in civil cases like marriage, inheritance of property, passport, insurance claims, disputed sex and missing persons etc. has got its own importance. In the present study 100 individuals are studied between the age group of 16 to 25 years in male and female (separately), whose X- ray examination is done at Rajindra Hospital ; Patiala, Punjab. Male and female individuals were studied with age interval of two years and ten cases from each age interval were taken. The study is undertaken to know the fusion of medial end of clavicle to know the fusion of epiphysis. In this study, every individual’s X-ray chest AP view is taken to know fusion of epiphysis at medial end of clavicle.

Proceso biológico del desarrollo epifisario:: aparición y formación del centro secundario de osificación / Processus biologique du développement épiphysaire:: survenue et formation du point d'ossification secondaire / Biological process of epiphyseal development:: appearance and formation of secondary center of ossification

Los huesos se constituyen de tejido conectivo especializado que conforma el principal órgano de soporte del cuerpo. Las epífisis de los huesos largos experimentan durante el período perinatal diversos cambios estructurales que conllevan a la formación del centro secundario de osificación (CSO), responsable del crecimiento esférico de la epífisis. En este artículo se exponen los cambios biológicos característicos de las diversas etapas del desarrollo del CSO, mediante una descripción detallada de los eventos histológicos que ocurren en cada etapa e ilustrando la coordinación de procesos y el patrón de desarrollo epifisario. Por consiguiente, este artículo facilitará la comprensión de dichos procesos, la creación de modelos matemáticos de los diferentes eventos y proporcionará una base teórica para trabajos futuros que investiguen el desarrollo y crecimiento epifisario(AU)

Bones are the specialized connective tissue shaping the main support organ of the body. Long bone epiphysis underwent many structural changes during the perinatal period leading to formation of a secondary center of ossification (SCO), accounting for the epiphyseal spherical growth. In present paper are exposed the characteristic biological changes of the different SCO development stages thorough a detailed description of histological events occurring in each stage and illustrating the processes coordination and the epiphyseal development pattern. Therefore, present article will allows the understanding of such processes, creation of mathematical models of different events, as well as a theoretical basis for future papers researching the epiphyseal development and growth(AU)

Les os sont constitués de tissu connectif spécialisé formant l'organe de support principal du corps. Les épiphyses des os longs subissent plusieurs changements de structure lors de la période périnatale impliquant la formation du point d'ossification sécondaire (POS), responsable de la croissance sphérique de l'épiphyse. Dans cet article, les changements biologiques caractéristiques des diverses étapes du développement du POS sont exposés par une description détaillée des évènements histologiques se produissant dans chaque étape, et en montrant la coordination des processus et le modèle de développement épiphysaire. Cet article va donc faciliter la compréhension de ces dits processus, la création de modèles mathématiques des différents évènements, et donner une base théorique pour des travaux futurs étudiant le développement et la croissance épiphysaires(AU)

Aspectos histológicos da epífise de crescimento ósseo em resposta ao exercício físico extenuante em camundongos / Histologic aspects of bone growth epiphysis after strenuous physical exercise in mice

Procurou-se identificar se existe alteração histológica na epífise de crescimento ósseo de camundongos submetidos a exercício físico extenuante. Para tanto, foi realizada uma pesquisa experimental com uma amostra de 8 camundongos, que ficaram em condições ambientes em um biotério, alimentados com água e ração comum, ad libitum. A ninhada foi dividida em dois grupos, um grupo controle e um grupo experimental, sendo que, o grupo experimental foi submetido a um exercício físico extenuante, caracterizado pelo aumento do nível de ácido láctico sanguíneo, realizado por 40 minutos/dia, durante 20 dias ininterruptos. Ao final da intervenção, foram confeccionadas lâminas histológicas, com cortes longitudinais do fêmur dos camundongos e analisadas em um microscópio óptico. Os dados obtidos mostraram alteração na estrutura epifisária do grupo experimental com aparente diminuição da zona proliferativa do disco epifisário, articulação mais desenvolvida e aumento das espículas ósseas com diminuição das trabéculas, sugerindo uma maturação precoce da epífise de crescimento. Através da análise dos resultados, conclui-se que o exercício físico extenuante modifica a estrutura da epífise de crescimento ósseo em camundongos.

The aim of this study was to identify histological alterations in bone growth epiphysis of mice submitted to a tiring physical exercise. For so, it was carried out an experimental research with a sample of 8 mice that stayed in environment conditions, fed with water and common feed, ad libitum. The brood was divided in two groups, a control group and an experimental group, being the experimental group submitted to a tiring physical exercise, characterized by the increasing of blood lactate level, carried out by 40 minutes/day, during 20 days uninterrupted. At the end of the intervention, were confectioned histological slides corresponding to the bone growth epiphysis of the femur of the mice and analyzed in an light microscope. Data showed an alteration in the epiphysis structure in the experimental group, with apparent decrease of the proliferation zone of epiphysis disc, an articulation more evolution and an increase of bone specula’s with a decrease of trabeculaes, what suggests an early maturation, accelerating the substitution of cartilaginous woven by bone weave. Through the analysis of the results, it was concluded that the tiring physical exercise modifies the structure of bone growth epiphysis in mice.

Comparação entre as idades óssea, dentária e cronológica por meio de método radiográfico simplificado / Comparison between bone age, dental age and chronologic age through radiographic simplified method

O objetivo deste estudo é a comparação entre a idade óssea, idade cronológica e o padrão de desenvolvimento dentário, com a finalidade de obter uma diretriz para a escolha da época de tratamento ortodôntico mais conveniente. Foram analisados clinicamente 140 pacientes, na faixa etária de 7 a 13 anos, de ambos os gêneros. Para a determinação da idade óssea esses mesmos pacientes foram submetidos a exame radiográfico da região da articulação metacarpofalangeana do primeiro dedo da mão esquerda, utilizando película radiográfica oclusal, pela técnica de cone longo (40 cm), com tempo de exposição de 0,9 segundo, para avaliação do desenvolvimento do osso sesamóide adutor. Conclui-se que o método radiológico empregado é de fácil aplicação, principalmente em cidades que não possuem centros radiológicos. A ossificação do osso sesamóide adutor pode ser utilizado como indicador do início do Surto de Crescimento Puberal (SCP) sendo mais precoce nos indivíduos de gênero feminino; o padrão dentário é variável tanto para a idade óssea como para a cronológica em ambos os gêneros.

The aim of this study is a comparison between bone age, chronologic age and dental age, with the purpose of to obtain a guideline for the choice of the treatment time more convenient. Were analyzed 140 patients both genre, in the age group from 7 to 13 year. For the determination of the bone age those same patients were submitted to radiographic exam of the metacarpophalangeal joint of the first finger of the left hand using radiographic oclusal film, for the technique of the long cone (40 cm), with time of exhibition of 0,9 seconds, for the evaluation of the development of the sesamoid adutor bone. The conclusions of this study were that the radiographic method used is a easy application, mainly in cities that do not have radiological centers. The ossification of sesamoid adutor bone can be utilized as an indicator of the beginning of Pubertal Growth Spurt (PGS), being more precocious in the individuals of feminine gender; the dental pattern is variable than for bone age than for chronologic age in both genres.

Age determination in girls of north – eastern region of India.

Epiphyseal union of the elbow, knee, wrist joints and pelvis was studied retrospectively on 104 girls between the age group of 16 -22 yrs to determine the age roentgenographically. Regression formula with the standard errors was derived for the respective joints. The Y-values predicted by the Regression equation may not be valid if they are out side the range of the Y-values used to determine the equation. The present study establishes a reference population for age determination of girls from epiphyseal union in North – Eastern region of India.

Age-related marrow conversion and developing epiphysis in the proximal femur: evaluation with STIR MR imaging / 华中科技大学学报（医学）（英德文版）

In order to observe the feature of age-related marrow conversion and maturation of epiphyseal cartilage and analyze the distribution of red and yellow marrow in the proximal femur at STIR MR imaging, STIR and T(1) weighted MR imaging of the proximal femur in 52 subjects, aged 4 months to 25 years old, were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The subjects with no known bone marrow abnormalities were divided into 6 age groups. The signal intensity of the marrow in the proximal epiphysis, proximal metaphysis, proximal diaphysis, distal diaphysis and greater trochanter was compared with the signal intensity and homogeneity of surrounding muscle and fat and graded by two observers. The results showed that the conversion of hematopoietic marrow in the proximal femur followed a well-defined sequence, occurring first in the proximal epiphysis, followed by the distal diaphysis, and then greater trochanter and metaphysis. STIR in combination with T(1)-weighted imaging could display clearly the origin of ossification center and the course of conversion from red to yellow marrow in proximal epiphysis and greater trochanter. STIR imaging showed that the marrow conversion in proximal metaphysic began below epiphyseal plate and intertrochanter. The site of red yellow was distributed in weight-bearing axis by 20 years of age. The marrow conversion of diaphysis was from distal end to proximal end, and the consequence of conversion was that distal diaphysis contained yellow marrow but proximal diaphysis partly red marrow connected with the red marrow of metaphysic. The epiphyseal cartilage had different characters of signal-intensity with age in STIR sequence. The distribution of red marrow in STIR imaging was more close to that of anatomy than T(1)-weighted imaging. It was concluded that STIR could dynamically display the feature of marrow conversion and the development of epiphyseal cartilage and accurately reveal the age-related distribution of red and yellow marrow on STIR imaging in the proximal femur.

Gadolinium-enhanced MR imaging of epiphyseal and metaphyseal marrow in normal piglets / 华中科技大学学报（医学）（英德文版）

The purpose of this study is to define the appearance of normal epiphyseal and metaphyseal marrow and normal changes of marrow due to fatty conversion on Gadolinium (Gd)-enhanced MR Imaging. Unenhanced and enhanced T1-weighted MR imaging were performed in proximal and distal femoral ends of 8 healthy piglets at the ages of 2, 4, 6 and 8 weeks, respectively. The changes with age in signal intensity and enhancement ratio of the epiphyseal and metaphyseal marrow with age were examined. The correlation of MRI characteristics with histological findings was studied. Our study showed that marrow of the metaphysis and of periphery of the 2nd ossification center were well vascularized hematopoietic marrow and had great enhancements. The enhancement ratio of metaphysis was greater than that of epiphyseal marrow and both enhancement ratios degraded gradually with age. The central regions of the epiphyseal ossification center and of the diaphysis were of fatty marrow and had little enhancement. It is concluded that on Gd-enhanced MR imaging the hematopoietic marrow of metaphysis and of periphery of the 2nd ossification center had greater enhancement than that of fatty marrow of central region of the 2nd ossification center. All of their enhancements decreased gradually with age.

Ocorrência de padröes radiológicos da epifisite do calcâneo em crianças assintomáticas / Occurrence of radiologic patterns related to calcaneum epiphysitis in asymptomatic children

Através de estudo radiográfico realizado em 250 crianças normais de ambos os sexos e de idades compreendidas na faixa de sete a 13 anos, na incidência lateral e axial posterior, colhemos dados sobre os aspectos da apófise posterior do calcâneo no intuito de estabelecer os parâmetros anatômicos normais. Os resultados obtidos permitem concluir que há ampla variaçäo de imagens e formas evolutivas da apófise posterior do calcâneo e que as imagens relacionadas pela literatura como elementos de diagnóstico da apofisite do calcâneo (doença de Haglund-Sever) ocorreram em grande número de crianças sem qualquer sintoma de enfermidade

Estudo experimental da reparaçäo das lesöes epifisárias tipo I e II de Salter e Harris / Experimental study on the healing of Salter and Harris type I and II physeal fracture separations

Foram provocadas lesöes epifisárias tipo I e II de Salter & Harris na epífise proximal da tíbia de ratos em crescimento e observado o processo de reparaçäo até 25 dias após. Com avaliaçäo realizada com radiografia, histologia e injeçäo vascular, concluiu-se que os resultados finais e o processo reparativo säo essencialmente os mesmos

Estudio ultrasonográfico del núcleo de osificación de la epífisis distal del fémur: tiempo de aparición, desarrollo y relación con el largo del fémur / Ultrasonographic evaluation of the distal femoral epiphyseal ossification nucleus time of appearence, development and relationship with the length of the femur

En 415 pacientes con embarazos normales desde 28 semanas hasta término, se estudió por ultrasonido el tiempo de aparición y las características de desarrollo del N.O.E.D.F. El primer núcleo fue visto a la 28ª semana y de allí en adelante el porcentaje de positividad aumentó a 86% para la 34ª semana y desde la 37ª semana prácticamente todos los fetos presentaron N.O.E.D.F. Igualmente, se observó un aumento progresivo de tamaño desde la forma lineal, pequeña, a la ovalada, mediana y a la grande que es típica del EAT. Esto fue cierto también para casos individuales seguidos longitudinalmente. Se observó, además, que a núcleos grandes correspondió fémur grande y que los otros tipos de núcleos coincidieron, en conjunto, con fémur más pequeño pero sin otra tendencia diferencial dentro del grupo. Se discuten las implicaciones clínicas de los datos encontrados relacionándolas en particular con el diagnóstico de edad gestacional y con los procesos de aumento de peso y de maduración del feto