Skeletal and chronological ages in American adolescents: Current findings in skeletal maturation

Ryan P Calfee,Melanie Sutter,Jennifer A Steffen,Charles A Goldfarb

doi:10.1007/s11832-010-0289-z

Ryan P Calfee, Melanie Sutter + Show 2 more

Open Access

https://doi.org/10.1007/s11832-010-0289-z

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Abstract

This study was designed to assess the relationship between skeletal and chronological ages among current American adolescents using the Greulich and Pyle atlas for skeletal age determination. We used the Greulich and Pyle atlas to prospectively determine skeletal age in a group of 138 otherwise healthy American adolescents from 12 to 18years of age. 62 males and 76 females were enrolled in this cohort. Paired Student t-tests were used to statistically compare the skeletal and chronological ages in this population. Subgroup analysis examined the effect of gender on differences between chronologic age and skeletal age. For the entire cohort, mean skeletal age was significantly greater than chronological age (mean 0.80years, P<0.01). In 29 cases (21%) the skeletal age was at least 2years greater than the chronologic age. Among females, such cases with marked discrepancy occurred exclusively in those chronologically between 12 and 15years of age (P<0.01). Males demonstrated a 2-year or greater discrepancy more commonly than females (26 vs. 17%). In males, 2-year discrepancies were equally likely across chronologic ages (P=0.82). Current American adolescents are significantly more mature by skeletal age, as determined by the Greulich and Pyle method, than their chronological age would suggest. The skeletal ages of females are most likely to markedly exceed chronologic age between the ages of 12-15years.

Highlights

The assessment of skeletal maturation in children and adolescents is necessary in clinical practice to determine the timing of varied interventions such as growth hormone administration and surgical epiphysiodesis
For the entire cohort, mean skeletal age was significantly greater than chronological age
Mean skeletal age was significantly greater than chronological age

Summary

Introduction

The assessment of skeletal maturation in children and adolescents is necessary in clinical practice to determine the timing of varied interventions such as growth hormone administration and surgical epiphysiodesis. One of the most common techniques used to detect differences between skeletal age and chronologic age is the Greulich and Pyle method This technique, developed in 1959, is based on a reference population of above-average social class adolescents from the 1930s [1]. The reviewer assesses similarities in epiphyseal development and physeal appearance between the subject’s radiograph and the reference standards for gender-specific skeletal maturity in the atlas. This technique assumes that the skeletal development of the hand and wrist is representative of the individual’s overall skeletal maturation [1, 2]

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