Iliac Apophysis - Risser's SignIn general the long bone growth plates close at 15 to 17 years in males and 13 to 15 years of age in females. An accurate way to determine the skeletal age of a child is to use an X ray of the left wrist and to compare it with X rays in the Greulich and Pyle atlas. Here a series of X rays showing the development and ossification of the wrist, and hand bones is displayed, together with the average age these appear. The axial skeleton matures a few years later than the limbs, and for scoliosis,the Risser sign is a useful method of bone age determination. Skeletal age can be determined by the appearance of the iliac apophysis of the pelvis. The apophysis appears laterally on a pelvic X ray, and moves towards the spine as the patient approaches adulthood. Risser's sign is a measures the growth left in the spine - this may help to determine the potential for progression of scoliosis.
A 'Risser 0' (before Risser 1) and Risser 5 are simlar in that both show no ossification centres on X ray. The two can be destinguished by age - an adolescent with Risser 5 grading will show no open growth plates in the long bones, and older be than 16 (female) or 18 (male), while a child with a Risser 0 grading will still have open growth plates in most of the long bones.
Age determination in other areasOther age determination systems are of value to the criminologist and immigration officials. It is sometimes crucial to determine if the individual is over 18 or 21, or at whatever age defines adulthood, and its attendant less lenient judicial treatment. The third molar roots appear on X rays at age 18 years. The ossification of the sternal clavicular cartilage also occurs at age 18 years.
1.Greulich WW, Pyle SI: Radiographic Atlas of Skeletal Development of the Hand and Wrist, 2nd edition. Stanford, . CA: Stanford University Press, 1959. | ||||||||||||||||||||||||||||
장골 골단의 골화는 전상장골극(ASIS)에서 시작하여 후상장골극(PSIS) 까지 진행하며, 일단 골화가 안정히 진행되면 장골능과 골유합 하게된다. Risser는 골화의 진행 정도를 5등분 하여 grade1은 장골능의 25%까지, grade2는 50%, grade3은 75% grade4는 끝까지 진행된 경우로 하였으며, grade5 는 장골에 유합되는 경우로 하였다. 장골의 골단은 여아에서는 평균 14.25세, 남아에서는 평균15.4세에 나타나며 골화가 완성되는 시기는 평균 2년이 걸린다.
Risser sign4 는 척추 성장의 종결과 일치하며, Risser sign 5가 되면 상체는 더 이상 크지 아니한다.
장골능의 골화의 진행 정도를 5등분
Grade1 : 25%
Grade2 : 50%
Grade3 : 75%
Grade4 : 끝까지 진행된 경우
Grade5 : 장골에 유합되는 경우
Risser sign4 는 척추 성장의 종결과 일치
Risser sign 5가 되면 상체는 더 이상 크지 아니함
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