Metacarpal index in short stature before and during growth hormone treatment

AIMS: To assess the usefulness of the metacarpal index (MCI) as a radiographic measure of the proportions of the metacarpals in the differential diagnosis of short stature. To investigate the significance of the MCI in following the longitudinal growth and proportions of individual long bones during growth hormone stimulated catch up growth in children with short stature with and without growth hormone deficiency. SUBJECTS: 124 children, including 65 children with short stature caused by growth hormone deficiency, 13 with familial short stature, 29 with idiopathic short stature, and 17 with Ullrich-Turner syndrome. METHODS: Retrospective analysis of the MCI in five posterior-anterior radiographs of the left hand of all patients, which were performed sequentially for routine bone age determinations (Greulich and Pyle) before and during the first three years of growth hormone treatment. RESULTS: The MCI was similar in all patient groups, resembled that of healthy children, and correlated significantly with chronological age, bone age, and height before and during growth hormone treatment. Despite a remarkable growth hormone stimulated catch up growth, the MCI did not change significantly during growth hormone treatment. CONCLUSIONS: The role of the MCI is insignificant in the diagnosis of short stature, but the MCI can serve as an auxological measure of osseous proportions during longitudinal growth. Growth hormone treatment accelerates longitudinal growth without affecting the proportions of the long bones, indicating that growth hormone stimulated bone growth closely resembles spontaneous bone growth.