Korean J Radiol.  2016 Jun;17(3):435-442. 10.3348/kjr.2016.17.3.435.

Maturation Disparity between Hand-Wrist Bones in a Chinese Sample of Normal Children: An Analysis Based on Automatic BoneXpert and Manual Greulich and Pyle Atlas Assessment

• Zhang J
• Lin F
• Ding X

• KMID: 2451417
• DOI: http://doi.org/10.3348/kjr.2016.17.3.435

Abstract

OBJECTIVE
To assess the maturation disparity of hand-wrist bones using the BoneXpert system and Greulich and Pyle (GP) atlas in a sample of normal children from China.
MATERIALS AND METHODS
Our study included 229 boys and 168 girls aged 2-14 years. The bones in the hand and wrist were divided into five groups: distal radius and ulna, metacarpals, proximal phalanges, middle phalanges and distal phalanges. Bone age (BA) was assessed separately using the automatic BoneXpert and GP atlas by two raters. Differences in the BA between the most advanced and retarded individual bones and bone groups were analyzed.
RESULTS
In 75.8% of children assessed with the BoneXpert and 59.4% of children assessed with the GP atlas, the BA difference between the most advanced and most retarded individual bones exceeded 2.0 years. The BA mean differences between the most advanced and most retarded individual bones were 2.58 and 2.25 years for the BoneXpert and GP atlas methods, respectively. Furthermore, for both methods, the middle phalanges were the most advanced group. The most retarded group was metacarpals for BoneXpert, while metacarpals and the distal radius and ulna were the most retarded groups according to the GP atlas. Overall, the BAs of the proximal and distal phalanges were closer to the chronological ages than those of the other bone groups.
CONCLUSION
Obvious and regular maturation disparities are common in normal children. Overall, the BAs of the proximal and distal phalanges are more useful for BA estimation than those of the other bone groups.

Keyword

Age determination by skeleton; Pattern recognition, automated; Developmental disabilities; Child; Radiography

MeSH Terms

Adolescent
Age Determination by Skeleton/*methods
Child
Child, Preschool
China
Female
Hand/*diagnostic imaging
Humans
Male
Pattern Recognition, Automated
Prospective Studies
Radiography
Wrist/*diagnostic imaging

Figure

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  Fig. 1 Greulich and Pyle (GP) BAs of 13 Radius-Ulna-Short bone and total BAs are automatically calculated by BoneXpert. BA = bone age

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  Fig. 2 Mean differences between bone ages and chronological ages (BA-CA) of five bone groups for boys using BoneXpert. Middle phalanges and metacarpals were most advanced and retarded groups, respectively, at almost all age levels.

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  Fig. 3 Differences between bone ages and chronological ages (BA-CA) of five bone groups for girls using BoneXpert. Middle phalanges group was most advanced group. Metacarpals group was most retarded group, except at some ages, when distal radius and ulna were more retarded.

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  Fig. 4 Mean differences between bone ages and chronological ages (BA-CA) of five bone groups determined using manual GP atlas for boys. Middle phalanges were most advanced group, and metacarpals and distal radius and ulna were most retarded groups at almost all age levels. GP = Greulich and Pyle

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  Fig. 5 Mean differences between bone ages and chronological ages (BA-CA) of five bone groups according to manual GP atlas for girls. Middle phalanges group was most advanced group at all age levels. Metacarpals group was most retarded group, except at some ages, when distal radius and ulna were more retarded. GP = Greulich and Pyle

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