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Bone age in the 21st century: is Greulich and Pyle’s atlas accurate for Israeli children?

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Abstract

Background

The applicability today of Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist (G&P) is uncertain.

Objective

The purpose of this study was to determine whether G&P is accurate in Israeli children today.

Materials and methods

Left-hand radiographs of 679 children (375 boys) ranging in age from 1 day to 18 years old were obtained for trauma in the period 2001–2009 and were evaluated for bone age according to G&P. Individual bone age was plotted against calendar age and smoothed to obtain the association between calendar age and bone age. Any difference was assessed with Wilcoxon signed-rank test.

Results

In girls, there was no significant difference between bone age and calendar age (P = 0.188). G&P underestimated bone age in boys <15 years old (median difference, 2.3 months; P < 0.0001) and overestimated bone age in boys ≥15 years old (median difference, 2.9 months; P = 0.0043). The largest median difference (5.4 months; P = 0.0003) was seen in boys 6–10 years old.

Conclusion

The differences between calendar age and bone age according to G&P were relatively small compared with normal variance and are unlikely to be of clinical importance.

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Authors and Affiliations

  1. Pediatric Imaging, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel

    Michalle Soudack, Aviva Ben-Shlush, Jeffrey Jacobson & Lisa Raviv-Zilka

  2. Department of Diagnostic Imaging, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Iris Eshed

  3. Pediatric Endocrinology Unit, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Orit Hamiel

Authors
  1. Michalle Soudack
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  2. Aviva Ben-Shlush
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  3. Jeffrey Jacobson
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  4. Lisa Raviv-Zilka
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  5. Iris Eshed
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  6. Orit Hamiel
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Corresponding author

Correspondence to Michalle Soudack.

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Soudack, M., Ben-Shlush, A., Jacobson, J. et al. Bone age in the 21st century: is Greulich and Pyle’s atlas accurate for Israeli children?. Pediatr Radiol 42, 343–348 (2012). https://doi.org/10.1007/s00247-011-2302-1

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  • DOI: https://doi.org/10.1007/s00247-011-2302-1

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