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Assessment of bone ages: is the Greulich-Pyle method sufficient for Turkish boys?
A Koc1, M Karaoglanoglu, M Erdogan
1Department of Pediatrics, Faculty of Medicine, Harran University, 63 100 Sanliurfa, Turkey. ahmetkoc1@hotmail.com
Insights
The Greulich-Pyle (GP) Atlas shows different skeletal maturation in Turkish boys compared to American children. Modifications are needed for accurate skeletal age assessment in Turkish populations.
Area of Science:
- Pediatric Endocrinology
- Orthodontics
- Anthropometry
Background:
- The Greulich-Pyle (GP) Atlas, developed from US children (1917-1942), is widely used for skeletal maturity assessment.
- Its applicability to diverse populations, like Turkish children, requires investigation.
Purpose of the Study:
- To evaluate the sufficiency of the GP Atlas for determining skeletal age in Turkish boys.
- To compare skeletal age determined by the GP Atlas with chronological age and pubertal development stages in Turkish boys.
Main Methods:
- Radiographs of 225 Turkish boys (7-17 years) were analyzed.
- Skeletal age was assessed using the GP Atlas.
- Pubic hair (PH) stages were determined using Tanner criteria.
- Mean skeletal ages were compared to chronological ages across age groups and PH stages.
Main Results:
- Skeletal ages were generally delayed compared to chronological ages in younger boys (7-13 years) and early pubertal stages (PH 1-3).
- Skeletal ages were advanced compared to chronological ages in older boys (14-17 years) and later pubertal stages (PH 4-5).
- Specific mean differences ranged from -0.76 to +0.89 years.
Conclusions:
- The GP Atlas demonstrates a different skeletal maturation tempo in Turkish boys compared to the original US cohort.
- The GP Atlas is not fully applicable to Turkish boys and may require modifications for accurate skeletal age determination.
- These findings highlight the need for population-specific standards in skeletal maturity assessment.
Background:
The Greulich-Pyle (GP) Atlas of skeletal maturation has been prepared in white children who born between 1917 and 1942 in the USA, and is frequently used for assessment of skeletal maturity. In this study, we investigated whether or not the GP method is sufficient for Turkish children for the determination of the skeletal age.
Methods:
Plain radiographies of left hands and wrists of 225 healthy boys between 7 and 17 years of age were taken. Pubic hair (PH) stages of boys were determined by using the Tanner criteria. Mean chronological ages and mean skeletal ages according to GP Atlas were compared for each age groups and each PH stage.
Results:
Mean skeletal ages were delayed 0.61, 0.72, 0.54, 0.39, 0.25, 0.39, and 0.32 years than the mean chronological ages in the 7-13 years age groups, respectively, and advanced 0.13, 0.01, 0.89, and 0.52 years in the 14-17 years age groups. In PH stages 1, 2, and 3, mean skeletal ages were delayed 0.67, 0.51 and 0.40 years than the mean chronological ages, respectively. In PH stages 4 and 5, mean skeletal ages were advanced 0.66 and 0.76 years than mean chronological ages.
Conclusion:
The results suggest that Turkish boys may have a different tempo of skeletal maturation during pubertal development from that of American children which GP standards were derived. Therefore, GP Atlas is not completely applicable to Turkish boys but can be used with some modification.
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