The reliability of bone age determination in central European children using the Greulich and Pyle method.

Groell, Reinhard; Lindbichler, Franz; Riepl, T; Gherra, L; Roposch, Andreas; Fötter, R.

doi:10.1259/bjr.72.857.10505010

Cited by 95 publications

(85 citation statements)

References 6 publications

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“…The results of this present study is consistent with those of previous studies by Groell et al, Schmidt et al, and Buken et al, [14][15][16]. In our study SA was delayed and differences were significant for both sexes except for in case of boys who were slightly advanced but the difference was not significant.…”

Section: Skeletal Age Estimationsupporting

confidence: 93%

Dental and Skeletal Maturity- A Biological Indicator of Chronologic Age

Rai

Saha

Yadav

et al. 2014

JCDR

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Section: Skeletal Age Estimationsupporting

confidence: 93%

Dental and Skeletal Maturity- A Biological Indicator of Chronologic Age

Rai

Saha

Yadav

et al. 2014

JCDR

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“…19 For a subgroup of children (n ϭ 74), bone age was assessed by an experienced observer with the atlas method of Greulich and Pyle, which was found to be reliable for central European children. 20 For evaluation of the current status of skeletal maturation, we calculated the difference between bone age and chronologic age (bone age delay ϭ bone age minus chronologic age, in years). Routine blood sampling was performed to monitor the therapy.…”

Section: Study Protocolmentioning

confidence: 99%

Obesity Among Children and Adolescents With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

et al. 2006

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OBJECTIVES. Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is the most common inherited disorder of adrenal steroid biosynthesis. Patients with the classic form of CAH show androgen excess, with or without salt wasting. There are few studies reporting on higher rates of overweight and obesity among children with CAH. In addition to its role in the regulation of energy balance, leptin is involved in various endocrine and metabolic pathways. In this context, elevated serum leptin levels were reported recently for patients with CAH and were thought to be involved in the development of obesity among these patients. Therefore, the aim of this study was to analyze BMI values, compared with population-based references, for children and adolescents with CAH. Possible contributing factors, such as glucocorticoid therapy, skeletal maturation, birth weight and length, and parental BMI, were correlated with current BMI SD scores (SDS). In addition, the implications of serum leptin levels, corrected for BMI, gender, and Tanner stage, were investigated.METHODS. We performed a cross-sectional retrospective study of 89 children and adolescents with CAH (48 female and 41 male subjects; age: 0.2-17.9 years) who presented in our outpatient department during 1 year. All individuals had classic CAH, confirmed with molecular genetic analyses, and received substitution therapy (glucocorticoids and mineralocorticoids, if necessary). The quality of therapy was monitored in follow-up visits every 3 to 6 months, on the basis of clinical presentation and laboratory measurement findings according to current guidelines. We grouped the patients into salt wasting and simple virilizing groups, as well as according to current metabolic control. Leptin levels were measured with a commercial radioimmunoassay and calculated as SDS. For statistical analyses, standard parametric and nonparametric methods were used.RESULTS. The chronologic ages of the children with CAH were between 0.20 and 17.9 years (mean Ϯ SD: 8.9 Ϯ 4.6 years). The BMI SDS of the whole group ranged from Ϫ2.7 to 4.3 (mean Ϯ SD: 0.88 Ϯ 1.3) and was significantly elevated above 0.www.pediatrics.org/cgi

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“…While this method has the advantages of simplicity and availability of multiple ossification centers for the evaluation of maturity, it is, however, qualitative and was compiled solely from Caucasian children who lived in the 1930s. Nevertheless, the Greulich and Pyle standards are, at present, the most commonly used method for skeletal age assessments throughout the world, regardless of ethnic background (3,4).In an attempt to overcome ethnic and racial differences in skeletal maturation, standards have been developed for the German, Scandinavian and Japanese populations (5-9). However, there are still many questions regarding the applicability of the Greulich and Pyle standards to today's American children of different ethnic backgrounds.…”

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confidence: 99%

Skeletal Age Determinations in Children of European and African Descent: Applicability of the Greulich and Pyle Standards

et al. 2001

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This study assesses the value of the Greulich and Pyle method in determining the skeletal ages of healthy American children of European and African descent born after the year 1980. The hand and wrist radiographs of 534 children (265 boys, 269 girls; 260 European-Americans [EA], 274 African-Americans [AA]), ages 0 to 19 y, were analyzed by two experienced pediatric radiologists blinded to the chronological age of the subjects. A difference score was calculated for each subject by subtracting chronological age from the mean bone ages scores provided by the two raters. One group t-tests were performed to verify the hypothesis that the mean difference score was equal to zero. Skeletal age determinations by the two radiologists showed a high degree of agreement by intraclass correlation coefficient (r ϭ 0.994). The range of values for differences in skeletal and chronological ages was very wide, indicating great individual variability. Comparisons between skeletal and chronological age only reached statistical significance in EA prepubertal girls, whose skeletal ages were delayed, on average, by three months (t ϭ Ϫ2.9; p ϭ 0.005). Mean difference between skeletal and chronological age in prepubertal children of African descent was 0.09 Ϯ 0.66 y, while that in children of European descent was Ϫ0.17 Ϯ 0.67 y; (t ϭ 3.13; p ϭ 0.0019). On average, the bone ages of 10% of all prepubertal AA children were 2 SD above the normative data in the Greulich and Pyle atlas, while the bone ages of 8% of all prepubertal EA children were 2 SD below. In contrast to the racial differences observed in prepubertal children, EA postpubertal males had significantly greater values for bone age than AA postpubertal males (t ϭ 2.03; p ϭ 0.05). In conclusion, variations in skeletal maturation in prepubertal children are greater than those reflected in the Greulich and Pyle atlas; prepubertal American children of European descent have significantly delayed skeletal maturation when compared with those of African descent; and, postpubertal EA males have significantly advanced skeletal maturation when compared with postpubertal AA males. New standards are needed to make clinical decisions that require reliable bone ages and to accurately represent a multiethnic pediatric population. Skeletal age is a frequently used diagnostic tool for the evaluation of endocrine, orthopedic, genetic, and renal disorders, to monitor response to medical therapy and to determine the growth potential of children (1). The method most widely used for bone age determination is the reference atlas of Greulich and Pyle, consisting of radiologic examinations of the left hand and wrist from subjects at different stages of skeletal maturation (2). While this method has the advantages of simplicity and availability of multiple ossification centers for the evaluation of maturity, it is, however, qualitative and was compiled solely from Caucasian children who lived in the 1930s. Nevertheless, the Greulich and Pyle standards are, at present, the most commonly used method for ske...

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The reliability of bone age determination in central European children using the Greulich and Pyle method.

Cited by 95 publications

References 6 publications

Dental and Skeletal Maturity- A Biological Indicator of Chronologic Age

Dental and Skeletal Maturity- A Biological Indicator of Chronologic Age

Obesity Among Children and Adolescents With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

Skeletal Age Determinations in Children of European and African Descent: Applicability of the Greulich and Pyle Standards

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