Growth Potential Interpretation for 14.5-Year-Old Patient
This patient has minimal remaining growth potential and will likely gain only 1-3 cm in final height, as bone age matching chronological age at 14 years indicates near-complete skeletal maturity with imminent epiphyseal closure. 1
Understanding the Bone Age Results
The key finding is that bone age (14 years) matches chronological age (14 years 6 months), which indicates this patient is progressing through skeletal maturation at a normal rate without delay or advancement. 2, 3
What This Means for Growth Potential
- Skeletal maturity occurs around age 14 in girls and age 16 in boys, marking the point when growth plates close and linear growth ceases. 1
- Since this patient's bone age is already 14 years, they are at or very near skeletal maturity regardless of sex. 1
- The standard deviation of 12.6 months indicates normal variability in the assessment method and does not change the clinical interpretation. 3, 4
Expected Remaining Growth
Growth potential is determined by the degree of epiphyseal closure, not by chronological age alone. 1, 2
- Patients with bone age of 14 years have minimal remaining growth potential, typically 1-3 cm at most. 1, 5
- Growth velocity drops dramatically as bone age approaches 14-16 years, with most linear growth completed by this stage. 1, 6
- Treatment interventions like growth hormone are contraindicated when bone age reaches this level, as open epiphyses are required for any meaningful height gain. 1, 2
Clinical Context and Pitfalls
The critical distinction is between bone age and chronological age - a patient could be chronologically 14 but have a bone age of 11 (indicating substantial remaining growth) or a bone age of 16 (indicating no remaining growth). 2, 5
- In this case, the concordance between bone age and chronological age at 14 years signals normal pubertal progression but limited future growth. 4, 5
- Surgical interventions requiring growth potential (such as guided growth techniques for limb deformities) must be performed at least 2-3 years before skeletal maturity, making this patient too mature for such procedures. 1
- Peak height velocity in girls occurs during Tanner stages 2-3 (mid-puberty), which has already passed by bone age 14. 6
Practical Implications
Any expectations for significant additional height gain should be tempered, as this patient is at the tail end of their growth trajectory. 1, 5
- If short stature is a concern, evaluation should have occurred years earlier when bone age was 11-12 years and growth interventions could have been effective. 1, 2
- The patient and family should be counseled that current height is very close to final adult height. 4, 5
- Nutritional optimization and weight-bearing exercise remain important for bone health and density, but will not meaningfully affect final height at this stage. 1