RESUMEN
PURPOSE: Determination of skeletal development in children is important. The most used evaluation method is to study left hand X-ray based on the standards depicted by Greulich and Pyle. The aim of our study was to compare the accuracy of a new sonographically based method with the standard method. MATERIAL AND METHODS: 160 consecutive evaluated children and adolescents (77 male, 83 female) who received a X-ray of the left hand were evaluated. Ultrasound examination of the same hand was performed on the same day using the BonAge system (Sunlight Medical Ltd., Israel). This system evaluates the relationship between the velocity of the wave (speed of sound) passing thorough the distal radial and ulna epiphysis and growth, using gender- and ethnicity-based algorithms. Three experienced investigators (U1-U3) analysed the X-ray and assigned bone age scores based on the Greulich and Pyle atlas (G and P). The investigators were blinded to the calendary age (CA) of the patient and also for the BonAge result. Correlation between BonAge system results and G and P was performed using SPSS 12.0.1. RESULTS: In 152 patients BonAge measurement could be performed successfully. The correlation between the three investigators using the G and P method was between 0.977 and 0.980; correlation between the BonAge system and the investigators (U1-U3) was 0.902 and 0.920. The paired t-test showed no significant differences between the BonAge system and the three investigators and also for the comparison between U1 and U2. There were significant differences between U1 vs. U3 and U2 vs. U3 (p < 0.05). DISCUSSION: The BonAge device demonstrates the ability to produce an sufficient assessment of bone age using an ultrasound method. The results are correlated with conventional skeletal age evaluation using the G and P method. Advantages of the ultrasound device are objectivity, lack of ionizing radiation, and easy accessibility. In the case of first investigation X-ray is necessary to look for dissociated skeletal age, dysplasia, and mineralisation.