Age estimation in children by measurement of carpals and epiphyses of radius and ulna and open apices in teeth: A pilot study

Estimation of skeletal age using radiographic images is widely used in assessing biological growth in clinical and auxological studies. The most frequently used areas for age estimation in children and adolescents are tooth and wrist/hand, both giving good results with only a low level of radiation. This pilot study of a sample of 150 Italian children and adolescents aged between 5 and 15 years focused on analyzing the possible applications of the proportion of carpal area (Ca) and teeth mineralization as a criterion of age estimation. The regression model, describing age as a linear function of gender (g), the ratio between carpal bones area and carpal area (Bo/Ca) and the measurement of open apices, yielded the following equation:Age=4.619+0.401g+0.551N0−0.647s+7.163Bo/Ca−0.123N0s.Age=4.619+0.401g+0.551N0−0.647s+7.163Bo/Ca−0.123N0s.The model explained 93% of the total variance (R2 = 0.93), the median of the absolute values of residuals (observed age minus predicted age) was 0.465 years, with an inter-quartile range (IQR) equalling 0.529 years, and a standard error of estimate of 0.73 years.