Text-Atlas of Skeletal Age Determination,

Text-Atlas of Skeletal Age Determination: MRI of the Hand and Wrist in Children collects in a single volume all that is currently known and applicable about the use of magnetic resonance imaging (MRI) for the assessment of bone age.

The radiographic examination of the hand/wrist was initially used to study skeletal development, correlating skeletal and chronological age in order to verify potential growth and whether a need for intervention was necessary. In recent years, the reasons for this examination have expanded beyond assessment of development,  into such areas as the law, sports and delving more deeply into nonimaging specialties, including  pediatric endocrinology, gastroenterology, hematology, oncology, genetics and metabolics.

The increase in the interest and importance of imaging in these evaluations, combined with the awareness of the potential harm from x-rays, especially in children, has prompted the scientific community to consider diagnostic modalities that do not involve ionizing radiation. In addition to avoiding the use of radiation, MRI has the additional potentially tremendous value in its intrinsic high soft tissue contrast resolution, which provides unique information on the bone marrow, cartilage, and muscles and soft tissues.

Part 1 focuses on the anatomic, social and legal aspects of bone age, providing a concise overview of the use of bone age determination in the medical, legal and social systems.  Included here are chapters on normal bone development, diseases affecting bone age, and pathological conditions that might obscure or alter the apparent bone age at the hand and wrist will discussed.  Chapters on the legal applications of bone age assessment include the problem of multiple coexistent ethnic groups in the medicolegal context and current international laws addressing the use of bone age assessment.  Finally, genetic and ethnic applications, as well as the effects of nutrition on bone age, are presented.

Part 2 focuses on the clinical use and application of MRI in the assessment of bone age.  This section begins with comparisons of MRI findings versus the results of bone age studies using ionizing radiation methods in normal individuals.  This is followed by a consideration of using bone age assessment methods in the diagnosis and treatment of specific diseases, such as celiac, genetic, and endocrine diseases.  Two special situations are covered next: The use of MRI bone age assessment in (1) athletes and (2) orthodontics.  Finally, MRI bone age assessment in the wrist, knee, and clavicle are considered as adjunct or alternative methods for bone age assessment.