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Bone Joint J. 2018 Aug;100-B(8):1106-1111. doi: 10.1302/0301-620X.100B8.BJJ-2017-1489.R1.

A quantitative method for the radiological assessment of skeletal maturity using the distal femur.

Author information

1
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA and Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio, USA.
2
University of Rochester, Rochester, New York, USA.
3
Division of Endocrinology and Diabetes, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
4
Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, USA.

Abstract

Aims:

Using 90% of final height as a benchmark, we sought to develop a quick, quantitative and reproducible method of estimating skeletal maturity based on topographical changes in the distal femoral physis.

Patients and Methods:

Serial radiographs of the distal femoral physis three years prior to, during, and two years following the chronological age associated with 90% of final height were analyzed in 81 healthy children. The distance from the tip of the central peak of the distal femoral physis to a line drawn across the physis was normalized to the physeal width.

Results:

A total of 389 radiographs of the distal femur with corresponding Greulich and Pyle bone ages and known chronological ages were measured. Children reached 90% of final height at a mean age of 11.3 years (sd 0.8) for girls and 13.2 years (sd 0.6) for boys. Linear regression analysis showed higher correlation coefficent in predicting the true age at 90% of final height using chronological age + gender + central peak value (R2 = 0.900) than chronological age + gender (R2 = 0.879) and Greulich and Pyle bone age + gender (R2 = 0.878).

Conclusion:

Chronological age + gender + central peak value provides more accurate prediction of 90% of final height compared with chronological age + gender and Greulich and Pyle bone age + gender. Cite this article: Bone Joint J 2018;100-B:1106-11.

KEYWORDS:

Chronological age; Distal femur; Peak height velocity; Skeletal maturity

PMID:
30062944
PMCID:
PMC6152884
[Available on 2019-08-01]
DOI:
10.1302/0301-620X.100B8.BJJ-2017-1489.R1
[Indexed for MEDLINE]

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