Abstract
ObjectivesTo validate adult height predictions (BX) using automated and Greulich–Pyle bone age determinations in children with chronic endocrine diseases.MethodsHeights and near-adult heights were measured in 82 patients (48 females) with chronic endocrinopathies at the age of 10.45 ± 2.12 y and at time of transition to adult care (17.98 ± 3.02 y). Further, bone age (BA) was assessed using the conventional Greulich–Pyle (GP) method by three experts, and by BoneXpert™. PAH were calculated using conventional BP tables and BoneXpert™.ResultsThe conventional and the automated BA determinations revealed a mean difference of 0.25 ± 0.72 y (p = 0.0027). The automated PAH by BoneXpert™ were 156.26 ± 0.86 cm (SDS − 2.01 ± 1.07) in females and 171.75 ± 1.6 cm (SDS − 1.29 ± 1.06) in males, compared to 153.95 ± 1.12 cm (SDS − 2.56 ± 1.5) in females and 169.31 ± 1.6 cm (SDS − 1.66 ± 1.56) in males by conventional BP, respectively and in comparison to near-adult heights 156.38 ± 5.84 cm (SDS − 1.91 ± 1.15) in females and 168.94 ± 8.18 cm (SDS − 1.72 ± 1.22) in males, respectively.ConclusionBA ratings and adult height predictions by BoneXpert™ in children with chronic endocrinopathies abolish rater-dependent variability and enhance reproducibility of estimates thereby refining care in growth disorders. Conventional methods may outperform automated analyses in specific cases.
Highlights
Growth failure is very common in patients with chronic endocrinopathies, and the determination of skeletal maturity plays a pivotal role in endocrine diagnostic and is important to evaluate the individual growth potential [1, 2]
The inter-rater variability of the conventional bone age (BA) determination according to Greulich and Pyle performed by three experienced raters was 0.88
Overall the automated BA was retarded by 0.86 ± 2.26 y (Table 2)
Summary
Growth failure is very common in patients with chronic endocrinopathies, and the determination of skeletal maturity (bone age, BA) plays a pivotal role in endocrine diagnostic and is important to evaluate the individual growth potential [1, 2]. The most widely used methods for BA assessment are the Tanner–Whitehouse (TW2, TW3) methods [3, 4] and Greulich and Pyle (GP) method For the latter, a trained rater with a background of pediatric endocrinology or pediatric radiology performs comparisons with the plates of the GP atlas from 1959 [4]. BoneXpertTM uses an adopted adult height prediction method (BX), which is an improvement and extension of the Bayley–Pinneau method (BP) [9]. It is validated for healthy children [10]. The objectives of this study were the validation of adult height predictions (BX) using automated Greulich–Pyle bone age determinations in children with chronic endocrine diseases.
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