Skeletal age assessment: A comparison of 3 methods

Introduction: The aim of this study was to evaluate the applicability of 3 methods of skeletal age assessment. Methods: The skeletal assessment methods of Greulich and Pyle (GP), Tanner et al (TW3), and Eklöf and Ringertz (ER) were used to analyze the dorsopalmar hand-wrist radiographs of 360 Brazilian children and adolescents (180 boys, 180 girls; ages, 7-15 years). The standard error of the mean and confidence intervals of the 3 assessment methods as well as the mean chronologic ages of both sexes and the age ranges studied were calculated. Results: Skeletal age means obtained with the GP and TW3 methods were close to chronologic age for both sexes. The ER method tended to overestimate skeletal age for the lower age groups, to correspond for the intermediate age groups, and to underestimate for the higher age groups in both sexes. The confidence interval confirmed that these data did not represent a statistically significant difference between chronologic and assessed skeletal ages; this means there is a high relationship between the studied sample data and the 3 standard methods. Determinate correction factors (regression equation) make each method more useful for the studied population. Conclusions: Although all methods reliably assessed age, correction factors are recommended for better adaptability to the studied population.