Skeletal maturity in 750 normal Pakistani children (400 males, 350 females) aged 1-18 y was determined by the Greulich-Pyle atlas system. Male children during first year and female children during first 2 y of life matured in conformity with Greulich-Pyle standards. After that period mean bone ages were lower than the American standards up to 15 y in males and 13 y in females (at or around puberty), which may be due to malnutrition, ill health or other environmental factors. After puberty bone ages were higher than the American standards indicating earlier maturity in Pakistani than Western children. Hence for the proper evaluation of skeletal age in a given region, a longitudinal study on individuals in that region to establish normal standards is necessary.
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