1 Jul classic bone age method of Greulich and Pyle in the Radiographic Atlas of Skeletal Development of the Hand and Wrist, are discussed. The Greulich–Pyle (GP) atlas is one of the most frequently used methods for the assessment of skeletal age around the world. After presentation of the GP. Radiographic Atlas of Skeletal Development of the Hand and Wrist: Medicine by William Walter Greulich (Author), S. Idell Pyle ( Author).

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Lazar L, Phillip M. This makes accurate SA assessment invaluable for diagnostic and therapeutic decisions in paediatrics, endocrinology, orthopaedics and orthodontics. All healthy volunteers were middle-class and born in Europe.

In addition, there is no study in South Asia that could be used as a precedent. Endocrinol Metab Clin N Am. Online Cited Jan 5. Plain anc of left hands and wrists for males from the healthy sample between 1 to 18 years of age for four ethnic groups were taken. All examinations were well tolerated and completed with no compliance issues.

Only one patient was estimated to be 2 years older by the MRI compared with the radiograph. Discussion In our study, we estimated the bone age by MRI and a radiograph of the left hand in accordance with GP criteria. Aimon Fatima for her invaluable help with the manuscript preparation. Elsevier About ScienceDirect Remote access Shopping cart Contact and support Terms and conditions Privacy policy We use cookies to help provide and enhance our service and tailor content and ads.

However, mean differences of more than 8 months are noted in atlad aged months and months.

The plots show the mean of the estimated ages from the two methods radiographs and MRIs on the x-axis, given in years, and the difference between the estimated ages on the y-axis, also given in years. After presentation of the GP approach for the estimation of the bone age, much research has been conducted to examine the usability of this method in various geographic or ethnic categories.


The MR images of two healthy volunteers are presented in Figs.

Hand MRI and the Greulich-Pyle atlas in skeletal age estimation in adolescents

The study was conducted following the Declaration of Helsinki principles. A mean difference of atlaz than 13 months is observed between chronological age and bone age in all male age groups minimum mean difference The difference between our results and the GP results using 1 SD is likely attributable to skeletal maturation changes sincereflecting the different standard deviations compared with the GP atlas, but may also be influenced by the small number pyls cases in our study.

National Center For Health Statistics percentiles. Comparison of high-field-strength versus low-field-strength MRI of the shoulder. Bone age in children of diverse ethnicity. However, serial measurements of bone age by this atlas can be yreulich in management of growth related endocrine disorders in these children. About Us Contact Us.

An appraisal of Greulich-Pyle Atlas for skeletal age assessment in Pakistan

Support Center Support Center. The Bland-Altman plot for reader 1 shows that the estimated ages with MRIs and radiographs matched in seven children. Hand Clin ; 7: Stanford University Press; Approach atas skeletal maturation. Further prospective explorations taking these aspects into account should make the picture more vivid. The flow-chart for sample selection is given in Figure Conclusion MRI of the left hand is a feasible alternative to hand radiographs for skeletal age estimation in adolescents using the GP criteria with 2 SD.

Multicenter studies are necessary to confirm the study statements in a larger number of participants. MRI of the left hand is a feasible alternative to hand radiographs for skeletal age estimation in adolescents using the GP criteria with 2 SD. The chronologic age of the volunteers is shown greullch the x-axis and the differences greuich the assessed age and chronologic age on the y-axis, given in years.


The evaluation criteria for age estimation were the ossification stages of the epiphysis of the radius and ulna, carpal bones, metacarpal bones, thumb extensor and flexor sesamoid, and phalanges. The Bland-Altman plots for both readers are given in Fig.

Hand MRI and the Greulich-Pyle atlas in skeletal age estimation in adolescents

We gratefully acknowledge Ms. J Singapore Paediatr Soc ; Nuzhat Hassan 2 Dr. Radiographic atlas of skeletal development of the hand and wrist. The differences were statistically significant in freulich groups except adolescent males.

Roche found that the left hand was more advanced than the right hand [ 20 ], while Baer and Djrkatz found no such effect [ 21 ]. Am J Clin Nutr ; All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the Helsinki Declaration and its later amendments or comparable ethical standards.

Skeletal maturity and socio-economic status in Portuguese children and youths: A total of scans were thus selected. Results with p-value less than 0.

The mean difference between chronological age and bone age was less in females as compared to males 6. All of the treulich were native Europeans at least two generations of ancestors born in Europe.

Am J Dis Child ; Published online Jan Children of each gender were further ztlas into four groups. Bone age progression during the first year of growth hormone therapy in pre-pubertal children with idiopathic growth hormone deficiency, Turner syndrome or idiopathic short stature, and in short children born small for gestational age: All MRI examinations were performed on a short 1.

Bland Altman Plot females.