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Estimating Skeletal Maturity by Segmented Linear Modeling of Key AP Wrist Radiographic Parameters
Kira L Smith1,2, Ryan Furdock1,2, Joshua T Yuan3
1Department of Pediatric Orthopaedics, Rainbow Babies and Children's Hospital at Case Western Reserve University.
Journal of Pediatric Orthopedics
|January 30, 2025
Summary
An abbreviated Modified Fels wrist skeletal maturity system (mFels SMS) offers accurate skeletal age estimation using fewer parameters. This faster method enhances clinical utility for pediatric patients in outpatient settings.
Area of Science:
- Pediatric Radiology
- Skeletal Biology
- Growth and Development
Background:
- The Modified Fels wrist skeletal maturity system (mFels SMS) accurately estimates skeletal maturity from radiographs but requires 8 parameters.
- A simplified system could improve efficiency in clinical settings.
Purpose of the Study:
- To develop and evaluate abbreviated versions of the mFels SMS for faster skeletal maturity estimation.
- To compare the accuracy of abbreviated systems against the full mFels SMS and other established methods.
Main Methods:
- Analyzed 8 radiographic parameters of the mFels SMS in 80 children.
- Utilized regression and GEE analyses to identify key parameters for abbreviated systems (abFels SMS).
- Compared accuracy of abFels SMS options with mFels SMS, Greulich and Pyle (GP), and Sanders Hand System (SHS).
Main Results:
- Developed abFels SMS options requiring 2 to 7 parameters, with one option needing only 2 to 4.
- Full mFels SMS and all abFels SMS options demonstrated higher accuracy than GP and SHS.
- mFels SMS showed fewer outlier estimations than GP, with similar rates to SHS and abFels SMS options.
Conclusions:
- Abbreviated Fels wrist skeletal maturity systems provide skeletal age estimates with accuracy comparable to the full mFels SMS.
- These abbreviated systems require significantly fewer parameters, enabling quicker clinical application.
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