Related Experiment Video
Updated: Apr 17, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Use of Automated Bone Age for Critical Growth Assessment
Khalid M Khan1, Maria T Gonzalez-Bolanos2, Tara Holm2
1MedStar Georgetown University Hospital, Washington, DC, USA khalid.m.khan@medstar.net.
Background:
We compared the variability of bone age (BA) rating between clinicians and an automated system in children with congenital adrenal hyperplasia (CAH).
Method:
A total of 126 radiographs assessed by 3 clinicians blinded to patient details using Greulich and Pyle (GP) (readers 1, 2, and 3) and BoneXpert (BX).
Results:
Comparing BA rating with each other, the mean of the absolute differences varied from 0.42 ± 0.53 years (reader 1 and BX) to 0.57 ± 0.58 years (reader 2 and reader 3), P = .368. Comparing ratings that were consistent with all 4 methods (within 1 year of each other, 93/126, 74%) and the remaining, "outliers" (33/126, 26%), the outliers were younger (P = .003), smaller (height, P = .011, weight, P = .000), and prepubertal (P = .001).
Conclusion:
The variability of BA rating in CAH children is similar whether performed by clinicians or an automated system. The greatest variability was in prepubertal children.
