Skeletal age assessment: a comparison of 3 methods

Area of Science:

• Pediatric Endocrinology
• Orthodontics
• Forensic Anthropology

Background:

• Accurate skeletal age assessment is crucial for diagnosing growth disorders and determining developmental stages.
• Existing methods for skeletal age assessment include Greulich and Pyle (GP), Tanner et al (TW3), and Eklöf and Ringertz (ER).
• The applicability of these methods in diverse populations requires validation.

Purpose of the Study:

• To evaluate the applicability of the GP, TW3, and ER skeletal age assessment methods.
• To compare the accuracy of these methods in a Brazilian pediatric population.
• To determine if population-specific correction factors enhance accuracy.

Main Methods:

• Analysis of dorsopalmar hand-wrist radiographs from 360 Brazilian children and adolescents (ages 7-15 years).
• Application of Greulich and Pyle (GP), Tanner et al (TW3), and Eklöf and Ringertz (ER) skeletal age assessment methods.
• Calculation of standard errors, confidence intervals, and regression equations for each method.

Main Results:

• Skeletal ages assessed by GP and TW3 methods closely approximated chronological age in both sexes.
• The ER method showed a trend of overestimation in younger children and underestimation in older children.
• Confidence intervals indicated no statistically significant differences between chronological and assessed skeletal ages, suggesting a strong relationship with standard methods.
• Developed correction factors (regression equations) to improve method utility for the studied population.

Conclusions:

• All three skeletal age assessment methods (GP, TW3, ER) demonstrated reliability in the studied Brazilian population.
• Population-specific correction factors are recommended to enhance the adaptability and accuracy of these methods.
• Further research may refine these correction factors for precise skeletal age determination in diverse ethnic groups.