Growth Plate Closure and Height Variations in Children

Issues with Growth Plates

Hello, Doctor.
I have two questions to ask you.
The first one is, which area should be examined to accurately determine the closure of the vertebral growth plates? Does the closure of the vertebral growth plates occur faster than that of the hand? The second question is, what is the typical difference in height between a person in the morning and at night? It shouldn't be as much as 3-5 centimeters, right? Thank you, Doctor.

Sisi, 20~29 year old female. Ask Date: 2018/03/23

Dr. Shi Guozheng reply Orthopedics

1.
The closure of the growth plates is usually assessed by examining the wrist; by the age of 24, they are typically closed.
2.
The margin of error in height measurement is generally not that significant.

Reply Date: 2018/03/23

More Info

Understanding growth plate closure and its implications for height variations in children is a complex topic that involves several factors, including genetics, nutrition, and hormonal influences.
To address your first question regarding the assessment of spinal growth plate closure, it is important to note that the most reliable method for evaluating skeletal maturity is through X-ray imaging of the hand and wrist. This is because the growth plates in the hand and wrist are among the last to close, providing a clearer indication of overall skeletal maturity. While the spine does have growth plates, they are not as easily assessed through standard X-ray imaging, and the closure of spinal growth plates can vary significantly among individuals. Generally, the growth plates in the spine may close at a different rate compared to those in the hands, but they are typically not the primary focus when assessing growth potential.
In terms of growth plate closure timing, the growth plates in the spine usually close later than those in the hands. For most individuals, the growth plates in the long bones (like the femur and tibia) and the hand/wrist close around the ages of 16 to 18 for males and 14 to 16 for females. The spinal growth plates may remain open for a longer period, but this can vary based on individual development and hormonal factors.

Regarding your second question about the height differences due to early or late maturation, it is indeed possible for there to be a height variation of several centimeters between individuals who mature at different rates. The average difference can range from 3 to 5 centimeters, but in some cases, it can be more pronounced, especially if one individual experiences early maturation while another matures later. Factors such as genetics play a significant role in determining final adult height, and late bloomers may catch up in height during their growth spurts, which typically occur after the onset of puberty.

It's also essential to consider that while growth plates are a significant factor in determining height, other elements such as nutrition, physical activity, and overall health can influence growth patterns. For instance, adequate nutrition, including sufficient intake of calcium and vitamin D, is crucial for bone health and growth. Regular physical activity can also stimulate growth hormone production, which may contribute to height increases during the growth years.

In conclusion, understanding growth plate closure and its implications for height variations requires a comprehensive approach that considers various factors. If there are concerns about growth or development, it is advisable to consult with a pediatric endocrinologist or a specialist in growth and development. They can provide tailored assessments and recommendations based on individual circumstances, including potential interventions if necessary.

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