Figure 8.
X-rays of a 36-year-old female with severe untreated congenital hypothyroidism. (X-rays were kindly provided by Dr. Jonathan LoPresti, Keck School of Medicine, University of Southern California). A, Lateral and anteroposterior skull images showing persistently patent sutures and fontanelles and delayed tooth eruption. B, Lower limb x-ray showing severe epiphyseal dysgenesis with grossly delayed formation of secondary ossification centers (arrows). C, Hand x-ray demonstrating a 35-year delay in bone maturation (bone age, 14 months). D, Bone age advanced by 8 years after T4 replacement for a period of only 18 months, demonstrating rapid acceleration of endochondral ossification and “catch-up growth.”