Comparison of Radiographic Methods (The Gilsanz and Ratibin Atlas and Tanner-Whitehouse 2 and 3) of Bone Age Assessment With Chronological Age

Abstract

Introduction: Bone age assessment (BAA) can play an important role in legal and medical contexts. It can help determine a person’s legal rights and responsibilities, and can also be used to estimate their chronological age (CA) when accurate birth records are not available. BAA is used in situations such as identification, employment, criminal responsibility, judicial punishment, consent for marriage, and in sports competitions. In addition, it can also be used in cases where there is a need to estimate CA, such as during immigration or in conditions where birth records are not available. Methods: The study was approved by the Institutional Ethical Committee, and written consent was obtained from both children and their parents before participating in the study. Patients were selected based on specific inclusion and exclusion criteria. A data collection form was created for each participant. X-rays of the left hand and wrist were taken for all children referred to the X-ray Department at Sahyadri Speciality Hospital in Pune. The CA of the child was determined by their date of birth, and the bone age (BA) was assessed using radiographic methods. Result: The Bland–Altman plot is a statistical tool used to compare the agreement between two methods of measurement, in this case, the CA and Tanner-Whitehouse 2 (TW3) methods for BAA. The results of the comparison showed a statistically significant agreement between the TW3 method and the GR atlas. Conclusion: The TW2 method is not reliable for BAA. However, the TW3 method is considered reliable for assessing BA in older male children (ages 105–192 months) and younger female children (ages 13–104 months). On the other hand, the GR atlas appears to be more effective for younger male children (ages 13–104 months) and older female children (ages 105–192 months). In addition, the TW3 method can be used in conjunction with the GR atlas for older female children.