A primer on radiographic assessment of skeletal growth: Endocrine Control of Skeletal Maturation: Annotations to Bone Age Readings by Ze'ev Hochberg. Karger, 2003 CHF 84.00/EUR 60.00/US$73.25 (111 pages) ISBN 3 8055 7313 8

View Large Image | Download PowerPoint SlideRadiographic findings have long been used as a minimally invasive assessment of skeletal growth and overall physiological maturation. Recent advances in the basic understanding of the cellular and molecular basis of skeletal growth and its relationship to general health have stimulated a new interest in the use of radiography, both in basic medical practice and in academic scientific studies, to identify underlying biological mechanisms that are affecting growth and development. The small text Endocrine Control of Skeletal Maturation: Annotations to Bone Age Readings provides an excellent annotation to more standard types of atlas such as Greulich and Pyle or Tanner Whitehouse by providing an extensive set of references relating to underlying congenital, metabolic, endocrinological and nutritional alterations that affect growth and skeletal aging.The book is logically presented with the first two chapters examining the basics of bone maturation and growth. These chapters provide short, well-explained and well-illustrated sections on the basics of how various bones grow, the anatomical, histological and structural aspects of growth and maturation, and the relationship of these biological processes to radiographic findings. The middle section of the book describes the major endocrinological factors that affect skeletal growth and primary metabolic diseases that alter skeletal radiographic readings, including the effects of obesity, scurvy and renal failure. Although a number of congenital diseases are described in the text, these descriptions are used as examples for illustrating various molecular processes that underlie alterations in radiographic findings rather than as appropriate comparisons for the identification of the diseases that they illustrate. The last part of the book compares the use of this text in relation to the standard atlas-based methods of assessing bone age. A short segment on osteoporosis was included in the last section although it did not seem to follow the overall theme of the book, which was focused on growth and development.The book is carefully illustrated providing basic examples of processes involved in bone growth, coupled with excellent histological reviews of these processes and their relationships with observable changes as determined by radiographic findings. In the context of a review of radiological findings, only a small segment was devoted to relating plain film observations to other types of imaging approaches. This was disappointing because the use of numerous other modalities of skeletal imaging, including molecular resonance imaging (MRI), dual energy X-ray absorbtiometry (DXA) and quantitative computerized tomography (CT) are increasingly being used to augment plain film observations and a discussion of these would have been useful for purposes of comparison.As a basic scientist studying metabolic bone diseases and repair I found Endocrine Control of Skeletal Maturation an excellent practical primer for teaching purposes to illustrate bone growth and development. The illustrations and histological presentations are first rate. The summary of ‘big areas’ of endocrine regulation and the basics of relating radiographic findings to growth and underlying disease are all well presented, although in some cases details are lacking. The references are relatively contemporary and are a useful starting point for more detailed readings in this area. With the increasing use of plain radiography in laboratory-based animal studies, this small atlas is also an excellent starting place for learning the basics of using plain film for identifying potential cellular functions that might be compromised or affected under specific experimental conditions.