title: Measuring agreement between cervical vertebrae and hand-wrist maturation in determining skeletal age: reassessing the theory in patients with short stature.
abstract: BACKGROUND
  The objective of this study was to determine the degree of agreement between hand-wrist radiography and cervical vertebral maturation analysis in patients diagnosed with short stature.
  
  
  METHODS
  A cross-sectional study was designed; 178 patients (90 girls, 88 boys) diagnosed with short stature and seeking treatment were selected. The patients were divided into 2 groups (76 with familial short stature, 102 with nonfamilial short stature). Hand-wrist and lateral cephalometric radiographs were obtained from the patients. The hand-wrist radiographs were analyzed using the Fishman method, and the lateral cephalometric views were categorized according to the method of Hassel and Farman. The degree of agreement between the 2 methods of predicting skeletal maturation was measured by calculating the contingency coefficient and the weighted kappa statistic.
  
  
  RESULTS
  A high degree of agreement was observed between the 2 methods of analyzing skeletal maturation. It was also observed that agreement was higher in girls in the familial short-stature group, whereas boys had higher agreement in the nonfamilial short-stature group.
  
  
  CONCLUSIONS
  Cervical vertebral maturation can be a valuable substitute for hand-wrist radiography in patients with short stature.
authors.affiliation: Professor, Orthodontics Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahla Momeni
authors.initials: SM
authors.lastname: Danaei
authors.affiliation: Assisstant professor, Department of Orthodontics, School of Dentistry, Semnan University of Medical Sciences, Semnan, Iran.
authors.forename: Amirali
authors.initials: A
authors.lastname: Karamifar
authors.affiliation: Resident, Student Research Committee, Orthodontics Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: sadra.sardarian@yahoo.com.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Sardarian
authors.affiliation: Associate professor, Biomaterial Research Center, Department of Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shoaleh
authors.initials: S
authors.lastname: Shahidi
authors.affiliation: Professor, Department of Pediatric Medicine, Endocrinology Division, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamdollah
authors.initials: H
authors.lastname: Karamifar
authors.affiliation: Assistant professor, Department of Community Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Alipour
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, School of Dentistry, Shiraz, Iran.
authors.forename: Sahar
authors.initials: S
authors.lastname: Ghodsi Boushehri
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods* / Q000706:statistics & numerical data; D001827:Body Height / Q000502:physiology; D001846:Bone Development / Q000502:physiology; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000254:growth & development*; D002508:Cephalometry / Q000379:methods; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000254:growth & development*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000503:physiopathology*; D050276:Hand Bones / Q000000981:diagnostic imaging / Q000254:growth & development*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012737:Sex Factors