Editing Delayed puberty (section)

=== Imaging ===
[[File:X-ray of hand, where bone age is automatically found by BoneXpert software.jpg|thumb|Determination of bone age allows for comparison with chronological age and assessment of future growth potential.]]
Since bone maturation is a good indicator of overall physical maturation, an [[X-ray]] of the left hand and wrist to assess [[bone age]] usually reveals whether the child has reached a stage of physical maturation at which puberty should be occurring.<ref name=":1" /><ref name=":0" /> X-ray displaying a bone age <11 years in girls or <13 years in boys (despite a higher chronological age) is most often consistent with constitutional delay of puberty.<ref name=":0" /><ref name=":9" /> An MRI of the brain should be considered if neurological symptoms are present in addition to delayed puberty, two findings suspicious for pituitary or hypothalamic tumors.<ref name=":1" /><ref name=":7" /> An MRI can also confirm the diagnosis of [[Kallmann syndrome]] due to the absence or abnormal development of the olfactory tract.<ref name=":7" /> However, in the absence of clear neurological symptoms, an MRI may not be the most cost-effective option.<ref name=":7" /> A pelvic ultrasound can detect anatomical abnormalities including undescended testes and [[Müllerian agenesis]].<ref name=":1" /><ref name=":5" />