Tanner-Whitehouse bone age reference values for North American children

Area of Science:

• Pediatric Endocrinology
• Radiology
• Anthropometry

Background:

• Accurate bone age assessment is vital for evaluating pediatric growth and development.
• Existing bone age standards, such as the UK60, may not reflect contemporary population maturation rates.
• North American children's skeletal maturation may differ from historical British standards.

Purpose of the Study:

• To establish updated bone age reference values for North American children of European origin.
• To compare new reference values with existing standards (UK60).
• To provide a validated tool for assessing skeletal maturity in pediatric populations.

Main Methods:

• Analysis of 1090 hand and wrist X-ray films from 450 children (225 boys, 225 girls) aged 8-16 years.
• Utilized the Tanner-Whitehouse Mark 2 RUS (radius, ulna, and selected metacarpals and phalanges) method.
• Data collected from the Project Heartbeat longitudinal study in Houston, Texas.

Main Results:

• Developed US90 bone age reference values for North American children.
• US90 children demonstrated earlier skeletal maturation compared to UK60 standards.
• Maturation timing was approximately 3 months earlier than contemporary Spanish children.

Conclusions:

• The US90 reference values are recommended for use in North America.
• Updated standards are necessary due to observed secular trends in maturation.
• Further extensive surveys are pending to confirm these findings.