Abstract
ObjectivesTo assess the effect of secular change on skeletal maturation and thus on the applicability of the Greulich and Pyle (G&P) and Tanner and Whitehouse (TW3) methods.MethodsBoneXpert was used to assess bone age from 392 hand trauma radiographs (206 males, 257 left). The paired sample t test was performed to assess the difference between mean bone age (BA) and mean chronological age (CA). ANOVA was used to assess the differences between groups based on socioeconomic status (taken from the Index of Multiple Deprivation).ResultsCA ranged from 2 to 15 years for females and 2.5 to 15 years for males. Numbers of children living in low, average and high socioeconomic areas were 216 (55%), 74 (19%) and 102 (26%) respectively. We found no statistically significant difference between BA and CA when using G&P. However, using TW3, CA was underestimated in females beyond the age of 3 years, with significant differences between BA and CA (− 0.43 years, SD 1.05, p = < 0.001) but not in males (0.01 years, SD 0.97, p = 0.76). Of the difference in females, 17.8% was accounted for by socioeconomic status.ConclusionNo significant difference exists between BoneXpert-derived BA and CA when using the G&P atlas in our study population. There was a statistically significant underestimation of BoneXpert-derived BA compared with CA in females when using TW3, particularly in those from low and average socioeconomic backgrounds. Secular change has not led to significant advancement in skeletal maturation within our study population.Key Points• The Greulich and Pyle method can be applied to the present-day United Kingdom (UK) population.• The Tanner and Whitehouse (TW3) method consistently underestimates the age of twenty-first century UK females by an average of 5 months.• Secular change has not advanced skeletal maturity of present-day UK children compared with those of the mid-twentieth century.
Highlights
Bone age assessment plays an important role in clinical practice, permitting investigation of whether bone maturity is occurring at a rate consistent with chronological age (CA)
The Greulich and Pyle method can be applied to the present-day United Kingdom (UK) population
This study aims to use BoneXpert to test the applicability of the Greulich and Pyle (G&P) and TW3 methods to United Kingdom (UK) children born in the twenty-first century, whose standard of living is likely to be higher than that of the children used to develop the G&P and TW3 methods
Summary
Bone age assessment plays an important role in clinical practice, permitting investigation of whether bone maturity is occurring at a rate consistent with chronological age (CA). There is no precise figure, numbers are significant and authorities have faced challenges in estimating some of their ages [3]. In these situations, CA has occasionally been deduced by comparing BA of the individual in question with the existing BA standards [4]. CA has occasionally been deduced by comparing BA of the individual in question with the existing BA standards [4] This practice is common at geographical borders where conflicts or crises are occurring. The European Society of Paediatric Radiology musculoskeletal task force has recently advised against the practice of estimating chronological age based on an assessment of bone age [6]
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