Osseous Growth and Development

Abstract

IN the Fall of 1930 the Department of Child Hygiene, of the School of Public Health of Harvard University, in cooperation with the Boston Lying-in Hospital, and the Children's Hospital of Boston, began a study concerned with the growth and development of normal children. Only such children were included whose mothers had been followed in the Prenatal Clinic and subsequently delivered at the Lying-in Hospital. Obviously abnormal children were excluded from the series. From the time of birth these children were examined at frequent intervals and complete records kept of various factors having a bearing on their health, growth, and development. In addition to the careful clinical observations, roentgenograms of practically the entire body were made within 48 hours of birth. During the first year these were repeated at three-month intervals and thereafter at six-month intervals. Supplementary roentgenograms were sometimes taken between these periods. Two hundred and twenty-eight infants have had roentgenograms at birth (112 girls and 116 boys). The decreasing smaller number of cases at subsequent age periods indicates that only a percentage of these children have yet reached any given age period. For various reasons a few of these cases have been lost or dropped, but the relative proportion of boys and girls has remained practically the same. The study is still in progress and we hope ultimately to have a composite picture of normal growth and development of this group from birth to young adult life. All particulars will eventually be worked out in detail; correlating clinical, anthropometric, and roentgenologic data, but completion must necessarily await a good many years. In the meantime we felt it would be worth while to present certain information already available, which is concerned with osseous growth and development. In any attempt to evaluate the bone age from roentgenograms it is not only important to know the time at which the different osseous centers appear but also their size and contours at the different age periods. In addition to the variation consequent to age, there are fairly wide variations in normal children of the same age, commonly referred to as “normal” variations. Tables or graphs can give only a very rough idea of these variations and for essential features there is no good method of depicting these changes except by reproductions of roentgenograms or by reproductions of accurate black and white drawings of roentgenograms. In this paper we have used drawings because they can be reduced in size to save space and can be referred to easily.1 Ideally we might have reproduced the entire skeleton but for practical purposes the bones of the hands (including wrists) and bones of the feet were in most instances adequate. This is because in these structures we find a large number of ossification centers which are constantly changing in size and contour. Erratum in: https://doi.org/10.1148/31.5.635b