Application of ultrasound for bone age estimation in clinical practice.
OBJECTIVE
To assess the validity of bone age assessment by ultrasonography (US).


METHODS
Wrist US was performed on children (n = 100) undergoing radiographic bone age and compared with bone age estimation by a radiologist in the clinic and by endocrinologists under blinded conditions with Greulich and Pyle (GP) and Tanner and Whitehouse (TW3) methods.


RESULTS
The strongest correlation (r(2)) was seen in the radiographic bone age assessment between the 2 endocrinologists using the GP method (96.7%). The poorest correlation was seen when comparing radiographic methods to US of either wrist (74.6% to 82.6%). When bone age correlations were divided into normal, delayed or advanced, the highest correlation between the radiographic and US methods was found in the normal bone age group (80.9% to 86.1%) with weaker correlations for the delayed bone age group (77.1% to 86.9%) and the advanced bone age group (62.2% to 81.1%). US tended to overread delayed bone age and underread advanced bone age. US had poor positive and negative predictive value for identification of a normal or delayed bone age. The negative predictive value of US was 91% for an advanced bone age.


CONCLUSIONS
On the basis of our data, US assessment should not yet be considered a valid replacement for radiographic bone age determination.
Khan
Khalid M
KM
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA. khank@email.arizona.edu
Miller
Bradley S
BS
Hoggard
Eric
E
Somani
Arif
A
Sarafoglou
Kyriakie
K
D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D011884:Radius / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014457:Ulna / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult