In an ambitious leap forward in pediatric growth prediction, a novel study published in World Journal of Pediatrics elucidates a transformative approach to forecasting the final adult height in girls at the pivotal stage of menarche. This research harnesses the synergy of advanced imaging biomarkers and clinical data to develop an integrative predictive model. By combining analysis of bone age derived from left hand and wrist radiographs with knee radiomic scores and essential clinical characteristics, the investigators have crafted a tool with unprecedented precision and clinical utility.
The transition through menarche marks a critical juncture in female adolescent development, characterized by complex hormonal and physiological changes that influence growth trajectories. Historically, predicting final stature after menarche has posed significant challenges due to individual variability and limitations of traditional methods such as the Greulich-Pyle atlas-based bone age assessment. The current study addresses these limitations by leveraging cutting-edge quantitative imaging techniques alongside comprehensive clinical profiling.
Central to this research is the concept of bone age evaluation through radiographic analysis of the left hand and wrist. Bone age serves as a surrogate marker for skeletal maturity, reflecting the biological progress of bone development beyond mere chronological age. The researchers employed precise imaging techniques to quantify subtle ossification patterns and growth plate status, thereby refining skeletal age estimation beyond conventional visual comparison methods. This refinement enhances the reliability of skeletal maturity as a predictor of growth potential.
Complementing the bone age data, the study introduces the use of knee radiomic scores—a quantitative approach that extracts and analyzes complex imaging features from magnetic resonance imaging (MRI) scans of the knee joint. Radiomics involves high-throughput extraction of texture, shape, and intensity features from imaging data, capturing microstructural tissue characteristics undetectable by the naked eye. In this context, knee radiomic scores provide insight into cartilage and growth plate integrity, which are critical determinants of residual growth potential and final height outcomes.
Furthermore, incorporation of clinical characteristics such as chronological age, anthropometric measures, and hormonal profiles enriches the predictive capacity of the model. These variables contextualize the imaging findings within each individual’s unique developmental milieu, accounting for systemic influences on growth. The integrative model thus performs a multidimensional analysis that transcends isolated parameters, aiming to mirror the complex interplay of biological factors at menarche that influence ultimate stature.
Methodologically, the team adopted sophisticated statistical and machine learning approaches to combine these diverse data streams into a cohesive predictive framework. Through rigorous validation against longitudinal follow-up data, the model demonstrated superior accuracy in estimating final adult height compared to traditional bone age assessments alone. The enhanced predictive performance holds meaningful implications for clinical decision-making in pediatric endocrinology and growth monitoring.
One of the notable facets of this study is its potential impact on early intervention strategies. Accurate prediction of final height at menarche can facilitate timely identification of girls at risk for growth disorders or suboptimal stature outcomes. This capability may inform personalized treatment plans, including growth hormone therapy initiation or other therapeutic modalities, thereby improving long-term health and psychosocial well-being.
Moreover, the adoption of radiomic approaches underscores the growing integration of artificial intelligence and advanced computational methods in pediatric healthcare. By automating feature extraction and enabling data-driven insights, radiomics may redefine the landscape of diagnostic and prognostic tools available to clinicians. Such technological convergence exemplifies personalized medicine’s drive toward precision and efficiency.
In terms of clinical applicability, the use of the left hand and wrist for bone age assessment remains practical and widely accepted, while the emerging role of knee imaging expands the anatomical scope of growth evaluation. The dual-site imaging paradigm provides complementary information, with the wrist reflecting skeletal maturation and the knee offering a glimpse into growth plate status and musculoskeletal health.
The model’s development also entailed addressing challenges related to imaging standardization, data heterogeneity, and cohort variability. Ensuring reproducibility and generalizability required meticulous protocol design and cross-validation across diverse patient populations. This foundational work paves the way for broader implementation in varied clinical environments and demographic settings.
Future directions anticipated from this research include refinement of the model with additional biomarkers and longitudinal data integration, potentially encompassing genetic, metabolic, and environmental variables influencing growth. The convergence of multi-omic data sources with imaging and clinical indicators promises an even more holistic understanding of adolescent development.
The authors’ approach exemplifies how contemporary pediatric research can harness technological advancements to solve longstanding clinical dilemmas. By bridging traditional radiology with radiomics and clinical analytics, this study charts a promising path towards personalized growth prediction, enabling targeted interventions at a critical developmental window.
In conclusion, the integration of left hand and wrist bone age evaluation with knee radiomic analysis and clinical parameters constitutes a cutting-edge framework for predicting final height in girls at menarche. This innovation stands to transform growth monitoring and intervention strategies, offering clinicians a robust tool grounded in multifaceted, data-rich assessments. As this methodology gains validation and adoption, it heralds a new era of precision pediatric endocrinology, optimizing outcomes for countless young patients navigating the complexities of growth and development.
Subject of Research:
Final height prediction in girls at menarche through combined assessment of bone age, knee radiomics, and clinical characteristics.
Article Title:
Final height prediction of girls at menarche: a combined model using left hand and wrist bone age, knee radiomic scores, and clinical characteristics.
Article References:
Xu, XQ., Chen, Y., Wang, YR. et al. Final height prediction of girls at menarche: a combined model using left hand and wrist bone age, knee radiomic scores, and clinical characteristics. World J Pediatr (2025). https://doi.org/10.1007/s12519-025-01002-5
Image Credits:
AI Generated
DOI:
13 December 2025
