 |
|
Applicability of the Greulich and Pyle Skeletal Age Standards to Black and White Children of Today
Randall T. Loder, MD;
David T. Estle, MD;
Kenneth Morrison, MD;
Daniel Eggleston, MD;
Daniel N. Fish, MD;
Mary Lou Greenfield, MPH, RN;
Kenneth E. Guire, MS
Am J Dis Child. 1993;147(12):1329-1333.
Abstract
• Objective.
—The Greulich and Pyle skeletal age atlas was derived from white children of upper socioeconomic level during the 1930s. To our knowledge, the Greulich and Pyle standards have not been reassessed for both black and white children; it was the purpose of this study to reassess the applicability of these standards to today's children.
Design.
—A "blinded" review of hand roentgenograms taken for the evaluation of trauma was performed. Age of the subjects was evenly distributed between 0 and 18 years. The roentgenograms were scored for bone age by five individuals from different disciplines and levels of training. The difference between the median bone age and the child's chronologic age was calculated for each roentgenogram and stratified into four age groups: early childhood (0 to 4 years), middle childhood (4 to 8 years), late childhood (8 to 13 years), and adolescence (13 to 18 years).
Setting.
—The roentgenograms were obtained from four hospital emergency rooms in the Lake Erie basin area, the same geographic area from which the Greulich and Pyle standards originated.
Patients.
—There were 841 children: 452 boys and 389 girls, 461 black and 380 white children.
Results.
—The bone ages and chronologic ages were similar for white girls of all ages. Black girls were skeletally advanced by 0.4 to 0.7 year (P<.001), except during middle childhood. White boys were skeletally delayed during middle childhood by 0.9 year (P<.001) and during late childhood by 0.4 year (P<.01), but they were advanced during the adolescent years by 0.5 year (P<.01). Black boys showed no difference except for the adolescent group, which was skeletally advanced by 0.4 year (P<.02).
Conclusions.
—The Greulich and Pyle atlas is not applicable to all children today, especially black girls. We should be aware of this information when making clinical decisions requiring accurate bone ages.
(AJDC. 1993;147;1329-1333)
Author Affiliations
From the Section of Orthopedics (Drs Loder and Fish and Ms Greenfield) and Department of Biostatistics, School of Public Health (Mr Guire), University of Michigan, Ann Arbor; Departments of Orthopedics (Dr Loder) and Radiology (Dr Eggleston), Children's Hospital of Michigan, Detroit; Department of Radiology, Providence Hospital, Southfield, Mich (Dr Estle); and Department of Orthopedics, Medical College of Ohio, Toledo (Drs Loder and Morrison).
Footnotes
Accepted for publication June 21, 1993.
Reprint requests to Section of Orthopedic Surgery, University of Michigan, 1500 E Medical Center Dr, TC 2912K, Box 0328, Ann Arbor, Ml 48109-0328 (Dr Loder).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Comparison study of growth plate fusion using MRI versus plain radiographs as used in age determination for exclusion of overaged football players
George et al.
Br. J. Sports. Med. 2010;0:bjsm.2010.074948v1-bjsports74948.
ABSTRACT
| FULL TEXT
Variation in Methods of Predicting Adult Height for Children With Idiopathic Short Stature
Topor et al.
Pediatrics 2010;126:938-944.
ABSTRACT
| FULL TEXT
Skeletal age determination in adolescents involved in judicial procedures: from evidence-based principles to medical practice
Pruvost et al.
J. Med. Ethics 2010;36:71-74.
ABSTRACT
| FULL TEXT
Racial Differences in Growth Patterns of Children Assessed on the Basis of Bone Age
Zhang et al.
Radiology 2009;250:228-235.
ABSTRACT
| FULL TEXT
Age determination by magnetic resonance imaging of the wrist in adolescent male football players
Dvorak et al.
Br. J. Sports. Med. 2007;41:45-52.
ABSTRACT
| FULL TEXT
Effect of Knowledge of Chronologic Age on the Variability of Pediatric Bone Age Determined Using the Greulich and Pyle Standards
Berst et al.
Am. J. Roentgenol. 2001;176:507-510.
ABSTRACT
| FULL TEXT
|
