Tanner-Whitehouse bone age reference values for North American children.

On the basis of 1090 x-ray films from 225 boys and 225 girls ages 8 to 16 years-participants in the Project Heartbeat longitudinal study who were living in a generally above-average income environment near Houston, Tex.-we provide Tanner-Whitehouse Mark 2 RUS (radius, ulna, and selected metacarpals and phalanges) bone age reference values for North American children of European origin. We designate these values as US90 (for the 1990s) reference values, in contrast to the original British bone age standards, called UK60 (for the 1960s).

Diastolic runoff with widened arterial pulse pressure in an adolescent with widely metastatic testicular choriocarcinoma.

Widened arterial pulse pressure is often found with conditions having exaggerated diastolic runoff flow, such as aortic insufficiency and arteriovenous malformation. We report a 17-year-old boy with metastatic testicular choriocarcinoma and a widened pulse pressure. Ultrasonography and Doppler analysis revealed significant runoff flow into multiple large hepatic metastases.

Isolated bone relapse during hematologic remission in childhood acute lymphoblastic leukemia: report of a metatarsal relapse and review of the literature.

An 11-year-old boy with prior bone marrow and testicular relapses of his acute lymphoblastic leukemia (ALL) developed an isolated metatarsal bone relapse during complete hematologic remission 10 months after completion of chemotherapy. Although there was no radiographic or histologic evidence of additional occult leukemia, the polymerase chain reaction (PCR) technique detected a leukemic clone in both his bone marrow and metatarsal. A literature survey revealed only 10 reported cases of isolated bone relapse occurring during complete bone marrow remission in childhood ALL.

Reliability and validity of computer-assisted estimates of Tanner-Whitehouse skeletal maturity (CASAS): comparison with the manual method.

Three observers rated 57 X-rays from normal healthy children in Project HeartBeat! twice each by CASAS, the computer-assisted version of the TW2 RUS bone age method. Differences between duplicates of individual bone ratings which reached or exceeded 1.0 unit (or 1 stage) were 5% within observer and 8% between observers for CASAS, and 17 and 33%, respectively, for the unassisted MANUAL method.