Pediatric Endocrinology Expert Forum
Advanced bone age
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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Advanced bone age

Hi, my daughter is 2yrs 8 mo old, and was recently tested for bone age and hormone levels. Her breasts are developing and also has pubic, armpit and facial hair, as well as BO. The tests came back with the bone age of 4 yrs old. But the hormone levels are normal.
We just got a referral to an endo.
And I'm worried since I have PCOS and my mother has Hypothyroidism, any idea in what her problem might be? or is there a treatment?
Thanks,
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Early puberty in a girl is important to have evaluated, if her symptoms were just hair and body odor we would consider the adrenal gland and early adrenarche. With breast development it is important to rule out early hormone signals from the brain on her ovaries.
Workup will start with a physical exam, more than likely labs and a bone age may need to be done of the knee as she is very young and at times the xray of the wrist is not always as accurate. The endo may do additional testing to see if the signal from the brain is mature, this is called a leuprolide stim test and more than likely may be considered at another time, also a pelvic ultrasound may be helpful to rule out a simple cyst of the ovaries.
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