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The Upper Limb Cardiovascular Syndrome-Reply

Yves W. Brans, MD
Am J Dis Child. 1973;125(4):622-623. doi:10.1001/archpedi.1973.04160040116027.
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Drs. Poznanski, Stern, and Gall's constructive comments on the paper by Dr. Lintermans and myself illustrate once again how frail we are when science comes to interpreting facts.

Although the absence of carpal ossification centers probably has no diagnostic meaning, we still think that it is an interesting finding which has not been noted before. Without dwelling upon the controversy of determining skeletal age by means of a center-to-center approach (Garn et al) vs pictoral standards (Greulich-Pyle), we could have avoided confusion by stating that we preferred the latter. Furthermore, lines 34-ff of page 782 would make more sense if some words were restored. It should read: "....; the same holds true for a 5-month-old baby boy without ossification centers at the wrist and an 8-year-old girl lacking ossification centers of the triquetral, lunate, trapezius, trapizoid and scaphoid bones, and of the distal ulnar spiphysis, giving her an estimated bone age


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