title: Comparison between Greulich-Pyle and Girdany-Golden methods for estimating skeletal age of children in Pakistan.
abstract: OBJECTIVE
  To compare Greulich-Pyle (GP) and Girdany-Golden (GG) methods for estimation of Skeletal Age (SA) in children referred to a tertiary care hospital in Karachi, Pakistan.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan, from July 2010 to June 2012.
  
  
  METHODS
  Children up to the age of 18 years, who had undergone X-ray for the evaluation of trauma were included. Each X-ray was interpreted using both methods by two consultant paediatric radiologists having at least 10 years experience, who were blinded to the actual Chronologic Age (CA) of children.
  
  
  RESULTS
  A total of 283 children were included. No significant difference was noted in mean SA estimated by GP method and mean CA for female children (p=0.695). However, a significant difference was noted between mean CA and mean SA by GG method for females (p=0.011). For males, there was a significant difference between mean CA and mean SA estimated by both GP and GG methods. A stronger correlation was found between CA and SA estimated by GP method (r=0.943 for girls, r=0.915 for boys) as compared to GG method (r=0.909 for girls, r=0.865 for boys) respectively. Bland- Altman analysis also revealed that the two methods cannot be used interchangeably. Excellent correlation was seen between the two readers for both GP and GG methods.
  
  
  CONCLUSIONS
  There was no additional benefit of using GP and GG methods simultaneously over using GP method alone. Moreover, although GP was reliable in estimating SA in girls, it was unable to accurately assess SA in boys. Therefore, it would be ideal to develop indigenous standards of bone age estimation based on a representative sample of healthy native children.
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Awais
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Naila
authors.initials: N
authors.lastname: Nadeem
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Yousuf
authors.initials: Y
authors.lastname: Husen
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Abdul
authors.initials: A
authors.lastname: Rehman
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Madiha
authors.initials: M
authors.lastname: Beg
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Yasir Jamil
authors.initials: YJ
authors.lastname: Khattak
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D044466:Asian People; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D050276:Hand Bones / Q000000981:diagnostic imaging* / Q000254:growth & development; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan; D015203:Reproducibility of Results; D012727:Sex Characteristics; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000254:growth & development