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Original ArticleOpen Access
Humeral Head Ossification Center in Congenital Heart Disease
Lohitku S 
,
Jaovisidha S ,
Thongclzaiprasit K ,
Siriwongpairat P
,
Jaovisidha S ,
Thongclzaiprasit K ,
Siriwongpairat P SUPHANEEWAN JAOVISIDHA, M.D.*,
PIMJAI SIRIWONGPAIRAT, M.D.*
The objective of this study was to evaluate the ossification (visualization) of proximal
humeral ossification center (PHOC) which may indicate bone growth in infants with acyanotic and
cyanotic congenital heart disease (HD) compared to normal infants. The medical records and chest
radiographs within 3 months after birth of infants who were diagnosed as congenital HD by
echocardiography or cardiac catheterization from 1989 to 1999 were reviewed. The PHOC was
recorded from chest radiograph as presence or absence in every one-month interval since birth.
In all cases, the corrected age of 0 month was defined as 40 weeks post conception. We used a
study of 260 normal Korean infants as the normal population in this study. We found that from
67 cases enrolled in this study; 10 cases were excluded because of lack of complete medical
records and sequential chest radiographs. In the remaining 57 cases, the average gestational age
of the infants was 38.1
เธ‘
2.7 weeks and the average birth weight was 2860.5
เธ‘
597.7 grams.
Female to male ratio was 1.28: 1. The infants were classified by gestational age as term (75.4%)
and pre-term (24.6%). Types of congenital HD were diagnosed from echocardiogram (96.5%) and
cardiac catheterization (3.5%) of cases; and were divided as acyanotic HD (64.9%) and cyanotic
HD (35.1% ). The ossification of PHOC in acyanotic full-term infants at 0, 1, 2, and 3 months
was 24.0 per cent, 32.0 per cent, 72.0 per cent and 88.0 per cent; in cyanotic full-term infants
it was 27.8 per cent, 33.3 per cent, 77.8 per cent, and 94.4 per cent ; and in acyanotic pre-term
infants was 8.3 per cent, 8.3 per cent, 25.0 per cent, and 41.7 per cent, respectively. There were
2 cyanotic pre-term infants who did not show ossification of PHOC until 3 months. In full-term
infants with both types of HD; the appearance of PHOC was significantly later than normal at 1
month corrected age (p
=
0.000002) but not significant at 0, 2, and 3 months (p > 0.05); whereas,
in pre-term infants with acyanotic HD, the appearance was later than normal at 1, 2, and 3 months
(p
=
0.02, p
=
0.01, and p
=
0.0002, respectively). We concluded that the ossification of PHOC
is significantly later than normal in pre-term infants with congenital HD, but not significant
in
full-
term infants with congenital HD.
Key word : Congenital Heart Disease, Epiphysis, Humerus
PIMJAI SIRIWONGPAIRAT, M.D.*
The objective of this study was to evaluate the ossification (visualization) of proximal
humeral ossification center (PHOC) which may indicate bone growth in infants with acyanotic and
cyanotic congenital heart disease (HD) compared to normal infants. The medical records and chest
radiographs within 3 months after birth of infants who were diagnosed as congenital HD by
echocardiography or cardiac catheterization from 1989 to 1999 were reviewed. The PHOC was
recorded from chest radiograph as presence or absence in every one-month interval since birth.
In all cases, the corrected age of 0 month was defined as 40 weeks post conception. We used a
study of 260 normal Korean infants as the normal population in this study. We found that from
67 cases enrolled in this study; 10 cases were excluded because of lack of complete medical
records and sequential chest radiographs. In the remaining 57 cases, the average gestational age
of the infants was 38.1
เธ‘
2.7 weeks and the average birth weight was 2860.5
เธ‘
597.7 grams.
Female to male ratio was 1.28: 1. The infants were classified by gestational age as term (75.4%)
and pre-term (24.6%). Types of congenital HD were diagnosed from echocardiogram (96.5%) and
cardiac catheterization (3.5%) of cases; and were divided as acyanotic HD (64.9%) and cyanotic
HD (35.1% ). The ossification of PHOC in acyanotic full-term infants at 0, 1, 2, and 3 months
was 24.0 per cent, 32.0 per cent, 72.0 per cent and 88.0 per cent; in cyanotic full-term infants
it was 27.8 per cent, 33.3 per cent, 77.8 per cent, and 94.4 per cent ; and in acyanotic pre-term
infants was 8.3 per cent, 8.3 per cent, 25.0 per cent, and 41.7 per cent, respectively. There were
2 cyanotic pre-term infants who did not show ossification of PHOC until 3 months. In full-term
infants with both types of HD; the appearance of PHOC was significantly later than normal at 1
month corrected age (p
=
0.000002) but not significant at 0, 2, and 3 months (p > 0.05); whereas,
in pre-term infants with acyanotic HD, the appearance was later than normal at 1, 2, and 3 months
(p
=
0.02, p
=
0.01, and p
=
0.0002, respectively). We concluded that the ossification of PHOC
is significantly later than normal in pre-term infants with congenital HD, but not significant
in
full-
term infants with congenital HD.
Key word : Congenital Heart Disease, Epiphysis, Humerus
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