title: The utility of ultrasonographic bone age determination in detecting growth disturbances; a comparative study with the conventional radiographic technique.
abstract: OBJECTIVE
  To test whether the conventional radiographic technique in determining bone age abnormalities can be replaced by ultrasonography.
  
  
  METHODS
  A total of 54 Caucasian subjects up to 7 years of age with clinically suspected growth problems underwent left hand and wrist radiographic and ultrasonographic bone age estimations with the use of the Greulich-Pyle atlas. The ultrasonographic scans targeted the ossification centers in the radius and ulna distal epiphysis, carpal bones, epiphyses of the first and third metacarpals, and epiphysis of the middle phalanx, as described in previous reports. The degree of agreement between the two sets of data, as well as the accuracy of the ultrasonographic method in detecting radiographically suggested bone age abnormities, was examined.
  
  
  RESULTS
  The mean chronological age, radiographic bone age, and ultrasonographic bone age (all in months) were 41.96 ± 22.25, 26.68 ± 14.08, and 26.71 ± 13.50 in 28 boys and 43.62 ± 24.63, 30.12 ± 17.69, and 31.27 ± 18.06 in 26 girls, respectively. According to the Bland-Altman plot there was high agreement between the results of the two methods with only three outliers. The deviations in bone age from the chronological age taken by the two techniques had the same sign in all patients. Supposing radiography to be the method of reference, the sensitivity, specificity, positive predictive value, and negative predictive value of sonography in detecting growth abnormalities were all 100% in males and 90.9, 100, 100, and 93.8%, respectively, in females.
  
  
  CONCLUSIONS
  The conventional radiographic technique for determining bone age abnormalities could be replaced by ultrasonography.
authors.affiliation: Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Hajalioghli
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Tarzamni
authors.forename: Sara
authors.initials: S
authors.lastname: Arami
authors.forename: Daniel Fadaei
authors.initials: DF
authors.lastname: Fouladi
authors.forename: Morteza
authors.initials: M
authors.lastname: Ghojazadeh
mesh_terms: D000365:Age Determination by Skeleton / Q000379:methods*; D001848:Bone Diseases, Developmental / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D050276:Hand Bones / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*