Bone age assessment is an important part of the diagnostic and management pathway in children with growth and endocrine disorders. It is helpful in the diagnosis of various growth disorders and can provide a prediction of final height for patients presenting with short stature.
Bone age can also used in the to monitor children on growth hormone therapy or those presenting in delayed or advanced stages of puberty that may need treatment.
Assessment is performed with a radiograph of the non-dominant hand with a single DP view that includes the distal radius and ulna and all the fingers. Appearances of the carpal bones, metacarpal, phalanges, radius and ulna are compared to standardised versions in one of two main atlases:
- Greulich & Pyle atlas presents a single standardised image for a range of ages of each gender 1
- Tanner-Whitehouse atlas involves the scoring of each carpal bone, the radius and ulna leading to a total score, from which age can be estimated 2
- 1. Vicente Gilsanz, Osman Ratib. Hand Bone Age. ISBN: 9783540209515
- 2. William Walter Greulich, Sarah Idell Pyle. Radiographic Atlas of Skeletal Development of the Hand and Wrist. ISBN: 9780804703987
- 3. James Mourilyan Tanner. Assessment of Skeletal Maturity and Prediction of Adult Height (TW3 Method). ISBN: 9780702025112