{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T01:46:49Z","timestamp":1756000009067},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,2,19]],"date-time":"2018-02-19T00:00:00Z","timestamp":1518998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2018,2,19]],"date-time":"2018-02-19T00:00:00Z","timestamp":1518998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>When screening for Kashin\u2013Beck disease (KBD) in children, hand X-ray examination is the most important measure. However, there is high rate of misdiagnosis because of confusing X-ray signs. We studied the characteristics of positive and confusing hand X-ray signs. Clinical and radiological examinations were conducted in all 7- to 12-year-olds in selected villages from some KBD and non-KBD areas. We analysed the radiological and epidemiological characteristics of the X-ray signs of KBD and the confusing signs. Images from 3,193 children were valid. No cases of KBD were found. Seventeen children (0.53%) had X-ray signs positive for KBD. The confusing X-ray signs included closure reaction of metaphysis-epiphysis (CRME, 14.28%), thumb variation (0.22%), little finger variation (8.89%), the second metacarpal-phalangeal variation (0.13%) and cystic change (3.85%). The onset of CRME in children occurred earlier in girls (9) than in boys (10). The onset occurred earlier in KBD areas (9) than in non-KBD areas (10). The onset occurred earlier in Han children (9) than in Tibetan children (11). In summary, KBD was effectively controlled in all investigated KBD endemic villages, and the age range should be adjusted to 7- to 11-year-olds in Han children to reduce the misdiagnosis rates in KBD surveillance.<\/jats:p>","DOI":"10.1038\/s41598-018-21675-5","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T15:28:12Z","timestamp":1518535692000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The characteristics of positive and confusing hand X-ray signs in diagnosing Kashin\u2013Beck Disease in children in China"],"prefix":"10.1038","volume":"8","author":[{"given":"Quan-Quan","family":"Song","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Lian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Yan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Xia","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2018,2,19]]},"reference":[{"key":"21675_CR1","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/j.joca.2007.09.002","volume":"16","author":"J Cao","year":"2008","unstructured":"Cao, J. et al. Articular cartilage metabolism in patients with Kashin-Beck disease: an endemic osteoarthropathy in China. Osteoarthritis and Cartilage 16, 680\u2013688 (2008).","journal-title":"Osteoarthritis and Cartilage"},{"key":"21675_CR2","first-page":"380","volume":"30","author":"ZJ Zhao","year":"2017","unstructured":"Zhao, Z. J. et al. Detection of the Urinary Biomarkers PYD, CTX-II, and DPD in Patients with Kashin-Beck Disease in the Qinghai Province of China. Biomed Environ Sci 30, 380\u2013383 (2017).","journal-title":"Biomed Environ Sci"},{"key":"21675_CR3","unstructured":"Endemic Disease Control Center of China. Science Investigation Reports of Kashin-Beck Disease in Yongshou (1979\u20131982). Beijing: People\u2019s Medical Publishing House (1984)."},{"key":"21675_CR4","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1007\/s12519-012-0351-7","volume":"8","author":"LY Sun","year":"2012","unstructured":"Sun, L. Y., Yuan, L. J., Fu, Y., Deng, J. Y. & Wang, L. H. Prevalence of Kaschin-Beck disease among Tibetan children in Aba Tibetan and Qiang Autonomous Prefecture: a 3-year epidemiological survey. World Journal of Pediatrics 8, 140\u2013144 (2012).","journal-title":"World Journal of Pediatrics"},{"key":"21675_CR5","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1007\/s002640100236","volume":"25","author":"M Hinsenkamp","year":"2001","unstructured":"Hinsenkamp, M. et al. The anatomical distribution of radiological abnormalities in Kashin-Beck disease in Tibet. International Orthopaedics 25, 142\u2013146 (2001).","journal-title":"International Orthopaedics"},{"key":"21675_CR6","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1016\/j.joca.2015.01.009","volume":"23","author":"Q Fu","year":"2015","unstructured":"Fu, Q. et al. Radiographic features of hand osteoarthritis in adult Kashin-Beck Disease (KBD): the Yongshou KBD study. Osteoarthritis Cartilage 23, 868\u201373 (2015).","journal-title":"Osteoarthritis Cartilage"},{"key":"21675_CR7","first-page":"15","volume":"01","author":"HX Liu","year":"2014","unstructured":"Liu, H. X. et al. The emotions of X-ray image changes of children with Kaschin-Beck disease. Chin J Endemiol 01, 15\u201318 (2014).","journal-title":"Chin J Endemiol"},{"key":"21675_CR8","unstructured":"Chinese Ministry of Health. Control of Kaschin-Beck disease areas. Beijing (2012)."},{"key":"21675_CR9","first-page":"46","volume":"9","author":"DJ Zhen","year":"1983","unstructured":"Zhen, D. J. & Xu, G. H. The X-ray study and its clinical significance of variations of metacarpal and phalangeal eiphyses in healthy children in Changchun. J Norman Bethune Univ Med J Sci 9, 46\u201350 (1983).","journal-title":"J Norman Bethune Univ Med J Sci"},{"key":"21675_CR10","first-page":"101","volume":"13","author":"BL Liu","year":"1994","unstructured":"Liu, B. L. et al. Observation of several normal variations of metacarpal and phalanges on school-age children. Chin J Public Health 13, 101\u2013103 (1994).","journal-title":"Chin J Public Health"},{"key":"21675_CR11","unstructured":"Sun, D. J. Endemic Disease in China. Beijing: People\u2019s Medical Publishing House 12\u201330 (2017)."},{"key":"21675_CR12","first-page":"1252","volume":"35","author":"M Gao","year":"2014","unstructured":"Gao, M. et al. Change on the rate of children\u2019s finger metaphysics in the non-Kaschin-Beck disease areas of China. Chinese Journal of Epidemiology 35, 1252\u20131255 (2014).","journal-title":"Chinese Journal of Epidemiology"},{"key":"21675_CR13","unstructured":"Sun, D. J. et al. Diagnosis of Kashin-Beck disease. Beijing: People\u2019s Medical Publishing House 44\u201362 (2017)."},{"key":"21675_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3109\/03009749409117126","volume":"23","author":"E Allander","year":"1994","unstructured":"Allander, E. 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Chinese Journal of School Doctor 5, 321\u2013323 (2001).","journal-title":"Chinese Journal of School Doctor"},{"key":"21675_CR23","unstructured":"Chinese Ministry of Health. \u201cDiagnosis of Kashin-Beck Disease\u201d (WS\/T 207-2010), MOH of P.R.C (2010)."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-21675-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-21675-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-21675-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T02:32:50Z","timestamp":1671589970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-21675-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,19]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["21675"],"URL":"https:\/\/doi.org\/10.1038\/s41598-018-21675-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,19]]},"assertion":[{"value":"28 July 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"3277"}}