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Skeletal Changes and Lifetime Pelvic Widening Print E-mail
SciMed - Biology
TS-Si News Service   
Wednesday, 25 May 2011 15:00
Chapel Hill, NC, USA. New evidence shows that the pelvis hipbones continue to widen as people advance in age from 20 years to 79 years, even though growth in height has ceased.

By the age 20, most people have reached skeletal maturity and do not grow any taller. Until recently it was assumed that skeletal enlargement elsewhere in the body also stopped by age 20 and any observed widening was the result of increased body fat.


"I think it's a fairly common human experience that people find themselves to be wider at the age of 40 or 60 then they were at 20," said Laurence E. Dahners, MD, senior author of the study and a professor in the Department of Orthopaedics in the at the University of North Carolina (UNC) School of Medicine. "Our findings suggest that pelvic growth may contribute to people becoming wider and having a larger waist size as they get older, whether or not they also have an increase in body fat," Dahners said.



Pelvis and Vertebra

In this drawing, a 20-year-old's pelvis is represented in pink, and a 79-year-old's pelvis in black. The difference between the two is approximately one inch in width. Image created by Laurence Dahners, M.D.

Click Pic for Details
The pelvic width of the oldest patients in the study was, on average, nearly an inch larger than the youngest patients. This one-inch increase in pelvic diameter, by itself, could lead to an approximately three-inch increase in waist size from age 20 to age 79. If the rest of the body is widening commensurately, this might account for a significant portion of an increase in body weight of about one pound a year that many people experience during the same period, Dahners said.

Dahners and his UNC co-authors got the idea for the study, published in the Journal of Orthopaedic Research, after being surprised to see evidence of pelvic widening in X-rays from patients in an unrelated bursitis study. They searched the scientific literature and found no previous studies that directly examined whether or not the skeleton continues to widen after skeletal maturity.

So, they set out to examine that question themselves. They did so by using CT scans from 246 randomly selected patients to measure the width and height of the L4 vertebral body (as an indication of whether these patients were taller and larger overall), the width of the pelvic inlet (the birth canal opening in the middle of the pelvis), the distance between the femoral heads (hip joints) and the diameters of the femoral heads.

There were approximately 20 male and 20 female patients in each 10-year age group, from the 20-29 age group to the 70-79 age group.

Their results confirmed that the width of the pelvis, the width but not the height of L4 vertebral body, the distance between the femoral heads and the diameter of the femoral heads all continued to enlarge after skeletal maturity.

In particular, the fact that the pelvic inlet also widened is evidence of true pelvic growth rather than simple appositional bone formation, Dahners said. The pelvic inlet would be smaller if appositional bone formation were taking place, he said.

ParticipationFirst author of the study is Alexander A. Berger, a UNC medical student. Co-authors are Ryan May, a doctoral student in the UNC Gillings School of Global Public Health, Jordan B. Renner, MD, a professor in the departments of Radiology and Allied Health Sciences in the UNC School of Medicine, and Neal Viradia, an MD/MPH student at UNC.
CitationSurprising evidence of pelvic growth (widening) after skeletal maturity. Alexander A. Berger, Ryan May, Jordan B. Renner, Neal Viradia, Laurence E. Dahners. Journal of Orthopaedic Research 2011; ePub ahead of print. doi:10.1002/jor.21469

Abstract

Following an increase in length and width during childhood and adolescence, skeletal growth is generally assumed to stop. This study investigates the influence of aging on the dimensions of the pelvis and the L4 lumbar vertebra during adulthood. The dimensions of the pelvis, L4 vertebra, and femoral heads were calculated for 246 patients who had received pelvic and abdominal Computed Tomography scans from the UNC Health Care System. Linear regression analysis determined the significance of relationships between age and width of the pelvis. There was a strong correlation between increasing patient age and increasing width of the pelvis at the trochanters, (0.333 mm/year of age p<0.0001), at the iliac wings, (0.371 mm/year of age p < 0.0002), and between the femoral heads, indicating that the bony pelvis widens over 20 mm between the ages of 20 and 80. The pelvic inlet did not enlarge over time while the distance between the hips and the femoral head diameter did significantly increase. The height of L4 did not increase over time, but the L4 width did increase. These correlations were seen in both genders. Surprisingly, our results suggest that the pelvis and L4 vertebra increase in width after skeletal maturity and cessation of longitudinal growth.

Keywords: bone growth, pelvic widening, bone maturation, longitudinal growth, computed tomography.

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Last Updated on Wednesday, 25 May 2011 14:57
 
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