Comparison of Tanner-Whitehouse and Greulich-Pyle methods in a large scale Danish Survey

In Denmark no systematic investigation of skeletal development had been made prior to this investigation which involved 1009 school children aged 7–18 years in a transverse examination. The skeletal age was estimated according to the American atlas of Greulich-Pyle. The English system of Tanner-Whitehouse was also applied. In this latter method the stage of development of 20 selected bones in the hand and wrist is rated on a scale of 8 (in one case 9) possible stages. Each bone is awarded points according to its stage of development. These points are totalled for the 20 bones and reference to a table gives the skeletal age. The problem with this system is that the later stages of carpal bone development cannot be reliably placed on the scale. Their point system is calculated in such a way that a difference of one stage in rating of a single carpal bone in older children would give rise to a difference of up to two years in the skeletal age estimation. For younger children the method is, however, quite reliable. The investigation has shown that Greulich-Pyle's atlas can be applied to Danish children of 7-18 years of age provided that a correction of six months is made. A variable error of about four months was found when using Greulich-Pyle compared to about two months with Tanner-Whitehouse.     

Accuracy of dental age estimation charts: Schour and Massler,Ubelaker and the London Atlas

Dental age estimation charts are frequently used to assess maturity and estimate age. The aim of this study was to assess the accuracy of estimating age of three dental development charts (Schour and Massler, Ubelaker, and the London Atlas). The test sample was skeletal remains and dental radiographs of known‐age individuals (N = 1,506, prenatal to 23.94 years). Dental age was estimated using charts of Schour and Massler, Ubelaker, and The London Atlas. Dental and chronological ages were compared using a paired t‐test for the three methods. The absolute mean difference between dental and chronological age was calculated. Results show that all three methods under‐estimated age but the London Atlas performed better than Schour and Massler and Ubelaker in all measures. The mean difference for Schour and Massler and Ubelaker was ?0.76 and ?0.80 years (SD 1.27 year, N = 1,227) respectively and for the London Atlas was ?0.10 year (SD 0.97 year, N = 1,429). Further analysis by age category showed similar accuracy for all three methods for individuals younger than 1 year. For ages 1–18, the mean difference between dental and chronological ages was significant (P < 0.05) for Schour and Massler and Ubelaker and not significant (P > 0.05) for the London Atlas for most age categories. These findings show that the London Atlas performs better than Schour and Massler and Ubelaker and represents a substantial improvement in accuracy of dental age estimation from developing teeth. Am J Phys Anthropol 154:70–78, 2014. © 2014 Wiley Periodicals, Inc.     

Height, weight, and lines of arrested growth in young Guatemalan children

A cross-sectional study of height, weight and skeletal maturity as judged from radiographs of hand and wrist, of 1,412 children under seven years of age (694 boys and 718 girls) living in rural Guatemala was performed. Height and weight were compared to standards prepared by the Institute of Nutrition of Central America and Panama (INCAP). Skeletal age was assessed by the Tanner-Whitehouse and the Greulich and Pyle methods. All x-rays were read by the senior author. The children surveyed were significantly shorter and lighter than well noruished Guatemalan children. Differences were evident by age six months and at a maximum by age five years. Both methods showed skeletal age to lag behind chronological age so that the Guatemalan rural children mature at slower rates than either the British children or the Ohio, U.S.A., children, from whom the two sets of standards were developed. Children of both sexes with radio-opaque transverse lines at the metaphysis showed a consistent tendency to be shorter than children without such lines. Boys but not girls showed similar trends for weight. In general, the data are consistent with the view that the physical development in boys is more severely retarded by an adverse environment than that of girls.     

男性青少年脂肪组织分布与相对骨龄的关系——Fels追踪研究

本文对Fels追踪研究中8—17岁男性青少年的相对骨龄与脂肪分布类型之间的关系做了分析。按体重/身高~2调整后,如用每个年龄的三种皮褶厚度(ST)指数的均值表示脂肪分布类型的话,8—12岁时,脂肪分布类型呈外周型分布,但13岁后开始朝向心型发展呈全身性分布。如用肩胛下ST/(肩胛下ST+肱三头肌区ST)的比例表示的话,那么14—17岁时,相对骨龄早者(简称早组)与相对骨龄晚者(简称晚组)相比,前者有较明显的向心型分布倾向。13—14岁时,早组的上述比值的年增长明显大于晚组。但是,按脂肪分布类型指数等级的基线和体重/身高~2调整之后,7、11或14岁时的相对骨龄不能预测17岁时的脂肪分布类型指数的等级。所以,我们可以得出这样的结论:如按本文的比例指数加以定量的话,脂肪分布类型与男性青少年的相对骨龄只有微弱的关系。他们的脂肪分布类型可能与其它成熟指征(如男性青春期的第二性征)有明显的关系。     

Fatness and skeletal maturity of Belgian boys 12 through 17 years of age

Relationships between fatness and skeletal maturity are considered in a nationwide sample of 14,259 Belgian boys 12 through 17 years of age (The Leuven Growth Study of Belgian Boys). Absolute fatness was estimated from four skinfolds using the Drinkwater and Ross technique and from the sum of four skinfolds, and was related to skeletal maturity assessed by the Tanner-Whitehouse method (I and II). In addition, comparisons were made between the fattest 5% and leanest 5% of the boys at each age level. Correlations between the indices of fatness and skeletal age and relative skeletal age (the difference between skeletal and chronological ages) are positive and generally low, ranging from 0.12 to 0.39. They tend to decrease with age from 12 to 17 years. Comparisons between the extreme groups indicate that the leanest boys are more delayed in skeletal maturity, by about 0.8 years, than the fattest boys are advanced, by about 0.5 years. Stature data for the same boys are consistent with the skeletal maturity data and thus suggest that the size differences between the extreme groups are due in part to maturity differences. Over the age span 12 through 20 years, the leanest boys are reduced in stature by about – 1.2 standard deviations, while the fattest boys are larger in stature by about +0.6 standard deviation units. The size differences, however, persist after skeletal maturity is attained so that there may be a specific role for fatness in influencing statural growth.     

Skeletal maturity of Japanese children in Western Kyushu

This paper describes the skeletal maturity status of Japanese children in Western Kyushu and its variation within Japanese populations. Hand-wrist skeletal maturity was assessed by the Tanner-Whitehouse (1975) (TW2) method from radiographs of 500 boys and 485 girls aged from 4 to 15 years. Western Kyushu children showed retarded skeletal maturity scores (RUS, carpals, and 20-bone) under the age of 12 years for boys and 10 years for girls, and thereafter they were advanced in relation to the British standard. Within Japanese populations the present sample showed delayed maturity compared to Tokyo children, but was close to that of Sapporo children throughout the age range studied. However, the expected effect of secular trend suggested skeletal maturity more advanced for Tokyo children and somewhat advanced one for Sapporo children compared to that of Western Kyushu children.     

Problems in the aging of skeletal juveniles: Perspectives from maturation assessments of living children

We employ samples of children of known chronological age to demonstrate the significance of random and systematic effects on maturation in both dental and skeletal development. Differences between chronological age for dental age in young healthy Canadian children can be as much as 100% of the actual age of the children. For skeletal development by reference to Greulich-Pyle standards, three samples of known-age children from Mexico document parallel effects: 1) 183 six-year-old children have skeletal-based ages with a 95% confidence interval of 4–8 years; 2) 80% of 217 4.0–4.5-year-old children are underaged by 1–3 years; and 3) 130 children of skeletal age between 39 and 44 months are actually between 4 and 7.4 chronological years of age. The Mexican samples are drawn from a population living under conditions of environmental stress with chronic mild to moderate protein-energy malnutrition and moderate to high levels of infectious disease. These children may parallel those from the past, whose remains are studied by skeletal biologists or paleoanthropologists. Our findings reinforce concerns expressed in extant studies regarding the accuracy of age-at-death reconstructions. © 1996 Wiley-Liss, Inc.     

Skeletal maturity in Danish schoolchildren assessed by the TW2 method

Skeletal maturity was assessed from hand-wrist radiographs in a sample of 3,817 Danish schoolchildren aged 7 to 18 years using the new version of the bone-specific Tanner-Whitehouse scoring system, the TW2 method. In most of the age groups in both sexes the distributions of the bone maturity scores displayed marked departures from normality; percentiles for the scores were therefore counted from the raw data. On the average, over the total age range, the differences between the age equivalents (bone ages) for the fiftieth percentile and chronological age were close to zero in both sexes, indicating good agreement with the British standards. However, in the individual age groups, and in particular at adolescence, characteristic divergences from the standards occurred, apparently reflecting the developmental spurt.     

Bone maturation reflects the secular trend in growth

The aim of this study was to compare a series of X-rays from the mid-1990s with another taken in the mid-1980s in order to test the possibility that environmental causes affect the skeletal maturation. The first group of subjects included a total of 1,057 girls and 1, 055 boys participating in a project for Japan and China health research in 1986. The second group of subjects included a total of 382 girls and 629 boys participating in a project for bone mineral density research in 1996. The skeletal maturity score using the Tanner-Whitehouse 2-RUS method was used as the fundamental datum. This score was used to represent each group. The Wilcoxon's rank sum test was applied to examine the significance of the difference between the 1986 and the 1996 groups. The 1996 children had not matured more than the 1986 children; children in both groups reached the given scores at almost the same ages. In girls, there was little difference between the groups at 7 years of age, but it declined from 8 years of age onward. Some apparent differences arose at ages 14 and 15, but ceased by age 16 in girls. In boys, no differences were found in those aged from 7 to 17 years, except for 12-year-olds. We did not detect much of a difference in bone maturation between the 1986 and 1996 groups of children, and no differences in height during the same period. Our findings suggest that bone maturation reflects the secular trend in growth.     

手腕部与膝部骨龄之间的差异

本文分别用Fels和RWT法评定了4902对2—17岁儿童青少年的手腕部和膝部骨龄。男女各年龄组骨龄的平均绝对差值为0.34—0.87岁,标准差为0.31—0.68岁。8—11岁前,这两个值往往随年龄增加;14岁前,男性一般大于女性。最大差值范围为1.45—2.99岁,其年龄变化往往不规律,但11岁前(男)和9岁前(女)常常增加。手腕部和膝部骨龄之间所存在的较大的绝对差值不能完全用观察误差加以解释。两部位的骨龄不能互相替代。所以,用骨龄预测成人身高和确定干骺固定术的时间,至少在5％的儿童中明显地受到骨龄部位的影响。