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Accuracy of Skeletal Age Assessment in Children From Birth to 6 Years of Age With the Ultrasonographic Version of the Greulich-Pyle Atlas

Departments of Radiology (Y.B., S.A.K., H.H.E., D.A.) and Pediatrics (S.H., C.S.), Kirikkale University, School of Medicine, Süleyman Demirel Hospital, Kirikkale, Turkey.

Address correspondence and reprint requests to Yasemin Bilgili, MD, Sevil Sokak 16/3, 06590 Cebeci, Ankara, Turkey; e-mail: mykaradeniz{at}hotmail.com.

Objectives. For the evaluation of skeletal age, the methods of Greulich-Pyle and Tanner-Whitehouse are generally used in clinical practice. Our investigation was undertaken to determine whether the ultrasonographic version of the Greulich-Pyle atlas is capable of assessing skeletal age. If so, we aimed to describe the standards for the ultrasonographic version of the Greulich-Pyle atlas for each year during the first 6 years of life. Methods. Ninety-seven subjects underwent left hand and wrist radiography and ultrasonographic examination for bone age assessment during a 1.5-year study. Estimated bone ages derived from the plain radiography and "hand and wrist ultrasonography charts" interpreted by use of the Greulich-Pyle atlas were compared statistically. Results. The estimated bone ages from plain radiography and hand and wrist ultrasonography charts interpreted by use of the Greulich-Pyle atlas were significantly correlated; 71.1% of male patients had the same age in both methods, and in 84.4% of patients, the difference was less than 6 months. In 65.5% of female patients, both methods revealed the same age, and in 88.5% of them, the difference was less then 6 months. Conclusions. The ultrasonographic version of the Greulich-Pyle atlas can be used to estimate bone age even in ultrasonography departments. This method is highly correlated and a valid alternative to plain radiography for bone age estimation. This enables estimation of skeletal age in ultrasonography departments easily without exposing the patient to radiation.

Key Words: Greulich-Pyle atlas • hand and wrist • skeletal age • ultrasonography

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