Usefulness of the Sauvegrain Method of Bone Age Assessment in Indian Children



Bone age estimation is very useful in children undergoing epiphysiodesis or guided growth surgery especially during the years of accelerated growth. It may be noted that no data are available on bone age estimation for Indian children of this age group. Sauvegrain (French) method is a very useful and simple method for bone age assessment during the years of accelerated growth. We decided to check the usefulness and the accuracy of the Sauvegrain method in Indian children.

Materials and methods

A team of two pediatric orthopaedic surgeons and a radiologist scored elbow X-rays of 80 healthy children (40 boys and 40 girls), using the Sauvegrain method twice. Interobserver reliability and intraobserver reproducibility of the Sauvegrain scoring were assessed.


There was a very strong correlation between all observers in both rounds (r = > 0.8) and an excellent reproducibility by the same observer in both rounds (r = 0.955). Chronological and bone age are considered the same if the difference between them is less than 6 months. With this criterion bone and chronological ages matched in > 37% of boys and girls, similar to the study done in French children. In the nonmatching group, more children had delayed bone age compared to their chronological age.


The Sauvegrain method of bone age assessment described for French children was found to be useful in estimating bone age in Indian children. It is especially helpful in the clinical practice for detecting mismatch between the chronological and the radiological age before undertaking guided growth or epiphysiodesis.

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The authors thank Dr Hitesh Chauhan, Dr Hitesh Shah, Dr Rohini Patel and Dr Hiral Naik for their help in preparation of this manuscript.


We have not received any funding for this project. We or any of our family members have no commercial associations (for example consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Author information




PN (MS, DNB ortho) (Corresponding author)—study design, performed measurements, prepared manuscript. DG (M S, ortho.)—performed measurements. CB (MD, DNB, DMRE Radio Diagnosis)—performed measurements. KV (MD, MPH, PhD)—performed statistical analysis and helped in manuscript preparation. All the authors have significantly contributed to our paper. We do not have any other disclosures.

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Correspondence to Premal Naik.

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We have obtained an approval from Institutional Review Board. We have taken appropriate consent from the patients for this study which is in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Naik, P., Ganjwala, D., Bhatt, C. et al. Usefulness of the Sauvegrain Method of Bone Age Assessment in Indian Children. JOIO 55, 116–124 (2021).

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  • Sauvegrain method
  • Bone age estimation
  • Bone age
  • Chronological age
  • Accelerated phase of puberty
  • Guided growth
  • Epiphysiodesis