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Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population

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Relationship between hand and wrist bone age assessment methods.

Zhen Bian¹, Yuan Guo¹, XueMin Lyu¹

¹Department of Pediatric Orthopaedics, Bei Jing Ji Shui Tan Hospital, Beijing, China.

|September 29, 2020

Summary

This study validates simplified bone age assessment methods, showing good correlation with the Tanner-Whitehouse (TW) standard. These findings offer a more efficient approach to evaluating skeletal maturity in children.

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Area of Science:

Pediatric Orthopedics
Radiology
Endocrinology

Background:

Accurate skeletal maturity assessment is vital for managing pediatric growth disorders.
The Tanner-Whitehouse (TW) method is accurate but complex and time-consuming.
Simplified methods derived from the TW method aim to improve efficiency.

Purpose of the Study:

To investigate the relationships between different simplified bone age assessment methods.
To determine the interchangeability and accuracy of these methods for clinical use.

Main Methods:

A cross-sectional study analyzed 103 left hand and wrist X-rays from pediatric patients (2018-2019).
Bone age was assessed using the Distal Radius and Ulna (DRU) classification, Sanders (S) staging, Thumb ossification (T) index, and the TW method.
Somers delta correlation was used to analyze the interchangeability of the staging systems.

Main Results:

The radius (R) stages demonstrated strong correlations with Sanders (S), Thumb (T), and Ulna (U) stages (P < .05).
Specific subgrades showed minimal standard deviation, enabling precise age estimations (e.g., R6/R7 for 11-11.5 years, S3 for 12 years).
A simplified assessment combining DRU and digital stages was proposed for accurate bone age evaluation.

Conclusions:

The internal relationships between the DRU and digital staging systems are well-established.
The study provides a simplified, accurate method for bone age assessment by combining specific subgrades.
This approach can enhance the efficiency of skeletal maturity evaluation in pediatric care.