In a healthy 11‑year‑old boy, is the acromial apophyseal growth plate expected to be open?

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Acromial Apophyseal Growth Plate Status in an 11-Year-Old Boy

Yes, the acromial apophyseal growth plate is expected to be open in a healthy 11-year-old boy. 1

Normal Developmental Timeline of the Acromion

Based on MRI studies of normal skeletal development, the acromial process follows a predictable maturation sequence:

Formation of Secondary Ossification Centers

  • Acromial secondary ossification centers begin forming at age 10 years, which is significantly earlier than previously reported in older literature 1
  • At age 11, your patient would be in the early phase of secondary ossification center development, with the growth plate still open 1

Fusion Timeline

  • Fusion of the acromial primary and secondary ossification centers begins at age 14 years 1
  • Fusion is generally complete after age 16 years 1
  • Therefore, an 11-year-old boy is approximately 3 years away from even the beginning of fusion 1

Clinical Implications

Expected Imaging Findings

  • The cartilaginous precursor of the acromion conforms to the final shape of the structure even before ossification 1
  • The chondro-osseous interface becomes progressively more lobulated as development proceeds 1
  • On MRI, you may see the early appearance of secondary ossification centers, but the growth plate itself remains open 1

Important Distinction from Other Growth Plates

This timeline differs from other anatomical sites. For comparison, the calcaneal apophysis begins fusion at age 12 and is complete in 78% of children by ages 14-15 2, making the acromial growth plate relatively later in its closure timeline.

Relevance to Treatment Decisions

  • In patients under age 40 with open growth plates, certain osteoporosis medications should be used with caution or avoided 3
  • Specifically, PTH/PTHrP and romosozumab should only be used in adults with closed growth plates 3
  • Denosumab should be used with caution in patients with open growth plates 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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