Bone Age Study and growth catch-up

[ChicagoMom]

Does anyone have any experience with the bone age scans? L had hers about 3 weeks ago and the results came back with a 2 year bone growth delay. I know that this is ultimately a positive thing since it will hopefully mean we can recoup the last two years of possible growth. I'm just curious if anyone else has seen a growth delay like this that got turned around? L is quite small for her age (11) and is anxious for a growth spurt. I really pray she starts growing soon!

 

[Clash]

I think there are several parents in this position. It is quite common with CD in the small intestine. I'm going to tag a couple of parents that can give you their experience. Jmrogers4, my little penquin, mehita, CIC hmm there may be others. I'm sure they will be by soon with their experience.

My son's GI said that 1.5 to 2 years behind is what he generally sees and is usually made up when treatment gets the disease under control as ling as there is no scar tissue causing malabsorption issues in the TI area of the small bowel.

 

[Clash]

Also if he is on pred then results maybe delayed as well. Once off the pred and the maintenance med has the CD under control you should start to see vertical growth. Of course he may gain weight with pred but a lot of that will be water weight. I hope things start improving greatly for her quickly.

 

[Jmrogers4]

We had bone age scan done in December that showed Jack about 1 1/2 - 2 years behind. We also had initial blood tests done at that time to check for growth hormone which ended up showing he might be low. We had just started remicade at the time and he gained a bunch of weight so we were hoping for some good vertical growth as well and decided to weight 4 months and see what happened.
He was about 80th % in height before disease and just seemed to go farther down the line as time went on. He was 12th in December when we saw the endocrinologist and 14.5 with barely a start of puberty, he seemed stalled at the same point for the last 2 years. His brother who is 2 years younger is leaps and bounds ahead of him, with lots of body hair, voice change, etc as neither hubby nor I were late puberty, we figured it was either disease activity or something else causing the delay.
He has grown an inch since starting remicade in January but when we went back to endocrinologist for follow up he was very pleased with weight gain but not growth he had fallen another line down and is no at 10% so wanted to follow through with further testing. We just did those tests on Monday and are awaiting results but honestly I truly think it is all due to disease activity as MRE in December showed inflammation throughout small intestine even though all his blood work was in normal levels. I've posted a picture somewhere of him at first remicade infusion and about 3 1/2 months later and the difference is amazing so what I guess I'm saying is disease control plays a huge part and while we thought his disease was under control it was silently simmering away in his small intestine and our only clue was lack of growth/weight gain. But because of his I feel great attitude coupled with no other symptoms we thought it was just a matter of time and everytime I voiced concern over lack of growth I was always told he'll get there it's just a matter of time. It really wasn't until we were at the GI and I was talking about him taking driver's training and going to homecoming dance at high school that it really clicked with GI that it had been over 4 years since diagnosis and he really should be well into puberty that we got a referral to endocrinologist and even with the tests we had done last Monday which usually take several months to schedule the endocrinologist ended up moving kids around in order to get Jack in quickly based on his age and our window of shrinking time.
I guess what I'm saying is once disease is under control she should start growing and if not further study should be done to make sure disease is truly under control so you can have that growth.

 

[Farmwife]

Grace was a year and a half behind in bone age.
No worries yet.........she's only five and plenty of time to catch up.
She just went through a major growth spurt.

 

[Mehita]

We've never done a bone scan, but my son, now 14, has grown a lot since finally getting his disease under control with Remicade. I think his plateau had a lot to do with his small intestinal inflammation that we just were never able to get under control until now. If I had to guess, I'd say he's about a year behind. A year ago I would have said he was two years behind.

 

[awmom]

My son had his first bone scan when he was 17 and was still not growing well. We had switched GI because his previous one was not addressing his growth at all. Unfortunately his growth plates had closed so he will not grow anymore. His biggest growth spurt came after four weeks of EEN. Your daughter is still young and will grow as you get her disease under control. I do believe that liquid supplements can help simply because they are easily absorbed. You have time on your side and it seems like the doc is addressing the issue. Wish you and your daughter the best.

 

[my little penguin]

DS had a bone age but was within a year which is normal.
Cd stalled his growth .
After remicade and continuing en DS gained 35 lbs and grew 7-8 inches.
He is back to the 77% for weight and 68% for height so he is almost back to his normal curve .
It did take quite a while after remicade was started to see growth 6-8 months .
Weight was easier it came right away.


Formula was and still is key to keeping DS on the right growing trend.
Good luck

 

[crohnsinct]

Hey there...I am CIC. My daughter was dx'd at 11 and was on the small side and ridiculously low weight. Since getting the disease under control she has grown 6 1/2 inches and gained 32 pounds. The key is to get the disease under good control and be patient. Height was the last thing to fall into place for us and I would say it tool a good 6 months to a year for us to really notice good growth.

Good Luck!

 

[xmdmom]

Do you mean bone age xray or bone scan? (I've never heard of anything called bone age scan.) A bone age xray can give a predicted adult height. Whether or not you achieve that height depends on whether on your health, nutritional status and hormones (is GH, cortisol, thyroid normal). In Crohn's, control of the disease (keeping inflammation low) and having good nutrition are important for maximizing growth. Growth spurts happen with puberty which is often delayed in Crohn's. Although your daughter would like a growth spurt, when the pubertal growth spurt comes, growth plates close and growth slows and stops. For this reason, a later puberty may be better than an earlier puberty in terms of achieving one's growth potential. How much has she been growing each year? Does she have any signs of puberty?

 

[my little penguin]

I think the confusion is they probably had two things :
A hand xray to determine bone age -if growth plates were sealed yet .
And
A dexa scan to determine bone density .

DS had both.

Hence the confusing term " bone age scan"

 

[Bareket]

Hi Chicago-I have 3 kids, all small with very delayed bone age (2-3 years each) as shown by hand x-ray, otherwise healthy except that my middle may have Crohn's. Middle is under the care of a peds GI, all 3 go to a peds Endocrinologist.

My oldest (14 year old girl) went on growth hormones as she proved out to be HGH deficient. It was a great decision as she grew 2 inches in 5 months and has had no side effects. Bone age is very useful as you want to address the growth before growth plates fuse. If your 11 yo daughter is still growing at a good pace (2-3 inches/year) and has delayed bone age, her height should catch up to normal, probably without intervention. If her growth slows or stops (as all my kids have), then she may need HGH drugs.

My peds endocrinologist has been tracking them for years, they are 14, 13 and 12 respectively. I expect that my other 2 will need HGH, they are getting tested in a few weeks.

You still have time especially as your daughter's bone age is delayed. But if her growth has stopped you may want to discuss testing for HGH deficiency with a peds endocrinologist. Please let me know if you have questions on that.

 

[Jenn]

late to the party, but ditto. My son has had a hand x-ray to determine bone age, he too is about 2 years behind. We recheck each year with the endocrinologist. He is on the low-end of normal for growth hormone, so based on his bone-age, we won't do meds til later. He has not had any catch-up growth, but is growing again at a normal rate. But it is so hard to be patient, he is very tiny in middle school now.