Development of a simplified new method of bone age estimation using three bones of the hand and wrist.
Endocrine
; 84(3): 1135-1145, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38244121
ABSTRACT
Though the Greulich and Pyle (GP) method is easy, inter-observer variability, differential maturation of hand bones influences ratings. The Tanner-Whitehouse (TW) method is more accurate, but cumbersome. A simpler method combining the above, such that it utilizes fewer bones without affecting accuracy, would be widely used and more applicable in clinical practice. OBJECTIVES:
1. Devising a simplified method utilizing three bones of the hand and wrist for bone age (BA) assessment. 2. Testing whether the 3 bone method gives comparable results to standard methods (GP,TW2,TW3) in Indian children.METHODS:
Developmental stages and corresponding BA for radius, hamate, terminal phalanx (left middle finger) epiphyses combining stages from GP,TW3 atlases were described; BA were rated by two blinded observers. 3 bone method ratings were compared with the same dataset analyzed earlier using GP,TW2,TW3 (4 raters).RESULTS:
Radiographs analysed493 (Girls=226). Mean chronological age9.4 ± 4.6 yrs, mean BA 3 bone9.8 ± 4.8 yrs, GP9.6 ± 4.8 yrs, TW39.3 ± 4.5 yrs, TW29.9 ± 5.0 yrs. The 3 bone method demonstrated no significant inter-observer variability (p = 0.3, mean difference = 0.02 ± 0.6 yrs); a strong positive correlation (p < 0.0001) with GP (r = 0.985), TW3 (r = 0.983) and TW2 (r = 0.982) was noted. Bland-Altman plots demonstrated good agreement; the root mean square errors between 3 bone and GP,TW3,TW2 ratings were 0.6,0.7,0.6 years; mean differences were 0.19,0.49,-0.14 years respectively. Greatest proportion of outliers (beyond ±1.96 SD of mean difference) was between 6 and 8 years age for difference in 3 bone and GP, and between 4-6 years for difference in 3 bone and TW3,TW2.CONCLUSION:
The 3 bone method has multiple advantages; it is easier, tackles differential maturation of wrist and hand bones, has good reproducibility, without compromising on accuracy rendering it suitable for office practice.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Determinação da Idade pelo Esqueleto
/
Ossos da Mão
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article