Measuring agreement between cervical vertebrae and hand-wrist maturation in determining skeletal age: Reassessing the theory in patients with short stature

•Cervical vertebral maturation is a reliable method for determining skeletal maturation in patients with short stature.

IntroductionThe objective of this study was to determine the degree of agreement between hand-wrist radiography and cervical vertebral maturation analysis in patients diagnosed with short stature.MethodsA cross-sectional study was designed; 178 patients (90 girls, 88 boys) diagnosed with short stature and seeking treatment were selected. The patients were divided into 2 groups (76 with familial short stature, 102 with nonfamilial short stature). Hand-wrist and lateral cephalometric radiographs were obtained from the patients. The hand-wrist radiographs were analyzed using the Fishman method, and the lateral cephalometric views were categorized according to the method of Hassel and Farman. The degree of agreement between the 2 methods of predicting skeletal maturation was measured by calculating the contingency coefficient and the weighted kappa statistic.ResultsA high degree of agreement was observed between the 2 methods of analyzing skeletal maturation. It was also observed that agreement was higher in girls in the familial short-stature group, whereas boys had higher agreement in the nonfamilial short-stature group.ConclusionsCervical vertebral maturation can be a valuable substitute for hand-wrist radiography in patients with short stature.