Which of the following is NOT typically associated with delayed bone age?

• A. Hypothyroidism
• B. Growth hormone deficiency
• C. Cushing syndrome
• D. Marfan syndrome

Answer: (D)

Bone age reflects how quickly the skeleton matures and is often delayed when normal hormonal signals for growth are lacking. Hypothyroidism and growth hormone deficiency slow overall growth and delay skeletal maturation, so delayed bone age is typical in those conditions. Cushing syndrome, on the other hand, tends to accelerate bone maturation because excess cortisol promotes earlier epiphyseal closure, giving an advanced bone age rather than a delayed one. Marfan syndrome is a connective tissue disorder with normal or near-normal skeletal maturation; it is not characterized by delayed bone age. Therefore, Marfan syndrome is not typically associated with delayed bone age.