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TW3 bone age: RUS/CB and gender differences of percentiles for score and score increments
L Molinari1, T Gasser, R H Largo
1Abteilung Wachstum und Entwicklung, Universitätskinderklinik, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland. luciano.molinari@kispi.unizh.ch
Annals of Human Biology
|October 30, 2004
Summary
Longitudinal bone age progression data is limited. This study provides reference values for Tanner-Whitehouse 3 (TW3) bone age scores, revealing significant gender and skeletal region differences in maturation timing.
Area of Science:
- Pediatric Endocrinology
- Skeletal Maturation Research
- Growth and Development Studies
Background:
- Longitudinal data on bone age progression is scarce, limiting detailed understanding of developmental trajectories.
- Accurate bone age assessment is crucial for diagnosing and managing growth disorders.
Purpose of the Study:
- To establish reference values for Tanner-Whitehouse 3 (TW3) bone age scores and increments.
- To determine mean appearance times for all TW3 stages, including gender and skeletal region (RUS vs. CB) differences.
Main Methods:
- Utilized longitudinal bone age data from 232 subjects (3 months to 20 years) from the First Zurich Longitudinal Study (1954-1976).
- Calculated smoothed empirical percentiles for TW3 RUS and carpal bone (CB) scores, and score increments.
- Employed parametric censored regression to compute means and standard deviations of appearance times.
Main Results:
- Significant differences observed in TW3 scores and maturation timing between genders and between RUS and CB assessments.
- Boys exhibit delayed skeletal maturation compared to girls, with distinct patterns for RUS and CB.
- Girls achieve final TW3 bone age scores approximately two years earlier than boys, indicating more rapid skeletal maturation from childhood.
Conclusions:
- The study provides essential reference values for TW3 bone age progression, score increments, and appearance times.
- Highlights significant, largely unexplained, differences in skeletal maturation between radio-ulna/short bones (RUS) and carpal bone (CB) assessments, as well as between genders.