A computerized image analysis system for estimating Tanner-Whitehouse 2 bone age

A method for assigning Tanner-Whitehouse 2 skeletal maturity scores (or bone ages) to hand-wrist X-rays by an image analysis computer system is described. An operator positions the relevant area of the X-ray on a light box beneath a video camera. Correct positioning is assured by computer templates of each bone stage. Thereafter the process is automatic; the computer, not the operator, rates the bones. The system produces continuous stage scores, not discrete ones such as B, C or D. Data are given which show that the computer-assisted skeletal age score is more repeatable than the usual manual (or unassisted) rating. The absolute difference between duplicates averaged 0.25 stages; differences of as much as 1.0 stage occurred in only 3% of duplicates compared with 15% obtained in manual ratings.