Aim: Several bone age (BA) methods are in use today. The aim of this study was to introduce a framework for assessing the validity of a BA method by its ability to predict adult height (H) and to apply it to manual ratings based on Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW) and to the fully automated BoneXpert method. Material: The study used X-rays of 232 children from the First Zurich Longitudinal Study recorded close to each anniversary. Method: For each height measurement (h), we calculated the growth potential (gp), defined as gp = (Hh)/H. The standard deviation of the gp prediction error for children of the same age was taken as a measure of the validity of the BA method and averaged over the age range 10–18 years for boys and 8–16 years for girls to obtain the overall gp prediction error (GPPE). Results: Manual TW yielded GPPE = 1.32% [95% CI 1.28–1.36], and was significantly outperformed by manual GP with GPPE = 1.26% [1.22–1.30]. The automated rating obtained GPPE = 1.23%, and omitting radius and ulna yielded GPPE = 1.22%. Conclusion: Manual GP rating is better than manual TW rating in predicting adult height, and the fully automated method works as well as manual GP rating.

Tanner JM, Healy M, Goldstein H, Cameron N: Assessment of Skeletal Maturity and Prediction of Adult Height (TW3 Method), ed 3. London, Saunders/Harcourt, 2001.
Greulich WW, Pyle SI: Radiographic Atlas of Skeletal Development of the Hand and Wrist, ed 2. Stanford, Stanford University Press, 1959.
Thodberg HH, Kreiborg S, Juul A, Pedersen KD: The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 2009;28:52–66.
Thodberg HH: An automatic method for determination of bone age. J Clin Endocrinol Metab 2009;94:2239–2244.
Bayley N, Pinneau SR: Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards. J Pediatr 1952;40:423–441.
Martin DD, Deusch D, Schweizer R, Binder G, Thodberg HH, Ranke MB: Clinical application of automated Greulich-Pyle bone age in children with short stature, Pediatr Radiol 2009;39:598–607.
Van Rijn RR, Lequin MH, Thodberg HH: Automatic determination of Greulich and Pyle bone age in healthy Dutch children. Pediatr Radiol 2009;39:591–597.
Martin DD, Neuhof J, Jenni OG, Ranke MB, Thodberg HH: Automatic determination of left- and right-hand bone age in the First Zurich Longitudinal Study. Horm Res Paediatr 2010 (in press).
Tanner JM, Whitehouse RH, Marshall WA, Carter BS: Prediction of adult height from height, bone age, and occurrence of menarche, at ages 4–16 with allowance for midparent height. Arch Dis Child 1975;50:14–26.
Roche AF, Wainer H, Thiessen D: The RWT method for the prediction of adult stature. Pediatrics 1975;56:1027–1033.
Tanner J, Landt K, Cameron N, Carter B, Patel J: Prediction of adult height from height and bone age in childhood. A new system of equations (TW Mark II) based on a sample including very tall and very short children. Arch Dis Child 1983;58:767–776.
Thodberg HH, Jenni OG, Caflisch J, Ranke MB, Martin DD: Prediction of adult height based on automated determination of bone age. J Clin Endocrinol Metab, 2009 epublication ahead of print, November 19, 2009, doi:10.1210/jc.2009-1429.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.