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Can Bone Age Cause Or Delay Puberty?

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Posted on Sat, 4 Nov 2017
Question: Good day, My question is regarding growth during puberty. My son was only 4 feet 6 inches at age 12. We took him to an endocrinologist who said his bone was 9.5 and that he was Tanner: P1 G2. From age 12-14 he grew 3.5 inches both years. My son just turned 15. He only grew 2 inches from age 14-15. At the moment he is 5 feet 3.5 inches. Here are my questions. 1. If his bone age was only 9.5 at 12 years old, should he have started puberty at a later age? (As opposed to the XXXXXXX rating of P1G2 at age 12) 2. Why did he grow so much between 12-14 and stop at 14? I understand that PHV does not happen until XXXXXXX Stage 3 or 4. At age 12 he was only XXXXXXX Stage 2. 3. I guess my real question is if he likely has a growth spurt left. I am worried because he grew so little last year, when I was expecting him to catch up. Does puberty growth sometime come in waves? Do kids grow a lot, then slow down for a year only to have another growth spurt?
doctor
Answered by Dr. Elona (2 hours later)
Brief Answer:
I suggest contacting the pediatrician Endocrinologist.

Detailed Answer:
Hello,
I have gone through your question.

Boys tend to show the first physical changes of puberty between the ages of 10 and 16. They tend to grow most quickly between ages 12 and 15.

You should know that by age 16, most boys have stopped growing, but their muscles will continue to develop.

Normal growth — supported by good nutrition, enough sleep, and regular exercise — is one of the best overall indicators of your teen's good health.

Your teen's growth pattern is largely determined by genetics.
If the child is within the range of their mid-parental height, the child likely has familial short stature, (assuming the parents did not have medical issues limiting their growth).

1.Your son had a delayed bone age at 12 years old and in this case, it is common a short stature and delayed puberty.

While the constitutional delay of growth is a common cause of short stature, it should be considered a diagnosis of exclusion, first requiring ruling out other causes of short stature.

It is very important to obtain the parental heights and calculate a mid-parental height).

2. The growth rate can double during the adolescent growth spurt, increasing from 2 inches per year to 3 or 4 inches per year.After one to two years of rapid growth, the growth rate starts to slow. So, Yes the puberty growth can sometimes come in waves.

Some children mature at a slow tempo. These kids often look young for their age and are shorter than average. They go into puberty late and so they have their growth spurt later than most of their peers.

While this occurs, the child with the slow pace of maturation feels particularly short because his friends are all shooting up in height. In a year or two, however, the slowly maturing child will begin his growth spurt. By that time, his friends' growth will be slowing down and so the child will start to catch up to his peers.

Usually, he will continue to grow after his friends have stopped growing. Some boys with a slow tempo of maturation will still be growing after graduating from high school. Slowly maturing children can end up short, average, or tall as adults.

Hope this is helpful.
Regards.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Elona (7 days later)
Hello. Thanks for your message. But as I mentioned, my son had a delayed bone age at 12 years old (he was about 2 years behind), however, he started puberty at that age. (as noted by the doctor) Why wasn't his puberty also delayed by two years? I thought bone age and puberty were related. Are they related? Or is there the possibility that he started puberty, but could still have a bone delay of 2 years? IF he DOES still have a bone delay of 2 years, does that mean he could still grow after puberty is over?

Also, my question related to growth spurts and waves was more of an example like this: two years of growth of 3 inches each year, followed by one year of 2 inches followed by a year of 3-4 inches. Does that type of thing ever happen?

Thanks!

PS - father's height is 188 cm and mother's 156
doctor
Answered by Dr. Elona (20 hours later)
Brief Answer:
Yes,the bone age and puberty are related.

Detailed Answer:
Hi again.
I appologise for the late reply.

I can say that skeletal maturation directly influences the age of pubertal onset in normal boys.So bone age and puberty are related.

Puberty is a stage, not a defined point.
It can progress over 3 - 6 years or so in some and includes a series of changes including growth.

Linear growth will continue until the growth centers of the long bones close under the influence of pubertal hormones.

An x-ray of the wrist and hand can be analysed for open growth centers and confirm continuation or end of the growth period.

This means that it is not the stage of puberty that determine if your son will still grow or not.As i said ,if he had over growth centers if this hand or wrists X-ray that the linear growth is still possible.

I suggest to talk with a pediatric endocrinologist about his X-ray results and the continuation of his growth period.

-Yes as i said in our last discution,some child have their growth spurt later than most of their peers but this doesn't mean that the child will start to catch up to his peers.
Yes,it can happend that a chald can have two years of growth of 3 inches/ year, followed by one year of 2 inches followed by a year of 3 inches.

The predicted height for your son(according to my calculations)is 178,5 cm.
If he has not reached this height,i suggest to do an X ray of his hands and than consult your local endocrinologist.

Hope this is helpful.
Ragards.



Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Elona

Endocrinologist

Practicing since :2008

Answered : 941 Questions

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Can Bone Age Cause Or Delay Puberty?

Brief Answer: I suggest contacting the pediatrician Endocrinologist. Detailed Answer: Hello, I have gone through your question. Boys tend to show the first physical changes of puberty between the ages of 10 and 16. They tend to grow most quickly between ages 12 and 15. You should know that by age 16, most boys have stopped growing, but their muscles will continue to develop. Normal growth — supported by good nutrition, enough sleep, and regular exercise — is one of the best overall indicators of your teen's good health. Your teen's growth pattern is largely determined by genetics. If the child is within the range of their mid-parental height, the child likely has familial short stature, (assuming the parents did not have medical issues limiting their growth). 1.Your son had a delayed bone age at 12 years old and in this case, it is common a short stature and delayed puberty. While the constitutional delay of growth is a common cause of short stature, it should be considered a diagnosis of exclusion, first requiring ruling out other causes of short stature. It is very important to obtain the parental heights and calculate a mid-parental height). 2. The growth rate can double during the adolescent growth spurt, increasing from 2 inches per year to 3 or 4 inches per year.After one to two years of rapid growth, the growth rate starts to slow. So, Yes the puberty growth can sometimes come in waves. Some children mature at a slow tempo. These kids often look young for their age and are shorter than average. They go into puberty late and so they have their growth spurt later than most of their peers. While this occurs, the child with the slow pace of maturation feels particularly short because his friends are all shooting up in height. In a year or two, however, the slowly maturing child will begin his growth spurt. By that time, his friends' growth will be slowing down and so the child will start to catch up to his peers. Usually, he will continue to grow after his friends have stopped growing. Some boys with a slow tempo of maturation will still be growing after graduating from high school. Slowly maturing children can end up short, average, or tall as adults. Hope this is helpful. Regards.