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Ann Pediatr Endocrinol Metab > Volume 14(1); 2009 > Article
Clinical Significance of Cone-shaped Epiphysis and Brachymesophalangia of the Fifth Middle Phalanx in Korean Children with Normal Short Stature.
Yun Hye Jung, Eun Jung Choi, Im Jeong Choi, Su Young Hong, Jae Ho Yoo
1Department of Pediatrics, Maryknoll Medical Center, Busan, Korea.
2Department of Pediatrics, Ilsin Christian Hospital, Busan, Korea.
3Department of Pediatrics, College of Medicine, Dong-A University, Busan, Korea. pedendo@dau.ac.kr
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.
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).
This study suggests that BMP-5 and CSE-5 in Korean children with short stature are one contributable factor for adult height.
Keywords: Bone development;Dysplasia;Phalanges of fingers;Hand radiography;Body height
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