Joseph Coyle MBBCh, MRCPI, Presenter: Nothing to Disclose

Jean E O'Connor PhD, MSC, Abstract Co-Author: Nothing to Disclose

Liam Dominic Spence MBBCh, Abstract Co-Author: Nothing to Disclose

Jason Last, Abstract Co-Author: Nothing to Disclose

Abnormal stature in childhood and adolescence often requires investigation of skeletal development. The Greulich-Pyle atlas (1959) of the hand-wrist is used to assess the level of skeletal maturity. In cases of abnormal stature it may also be relevant to examine the epiphyses which are the greatest contributors to overall stature, namely the epiphyses at the knee. The radiographic appearance of skeletal development at the knee, at each of the Greulich-Pyle bone age intervals, has not previously been documented. We conducted a preliminary study to compare maturity indicators of the knee to those of the hand-wrist

Fifty-seven subjects (37 males; 20 females) aged 9-23 years were included. All individuals had an antero-posterior and lateral radiograph of the knee and a left or right postero-anterior hand-wrist radiograph. Each knee radiograph was examined according to the methods of O’Connor et al. (2008). A stage of epiphyseal union was assigned for each of the epiphyses of the femur, tibia and fibula. Maturity of the hand-wrist was examined according to the Greulich and Pyle atlas and a skeletal age assigned

Stages of union of the three epiphyses at the knee were correlated with Greulich-Pyle bone age in both males and females. Correlation coefficients of 0.934, 0.925 and 0.923 (P<0.01) respectively for males and 0.913, 0.892 and 0.962 (P<0.01) respectively for females were observed. The coefficients observed are higher than those recorded in previous studies and it is possible that the staging system used for observation of epiphyseal union at the knee demonstrates a tighter correlation with maturity of the hand-wrist. Further recruitment is necessary to verify this observation

Understanding how development of the hand-wrist reflects maturation at other regions of the skeleton is of importance in clinical disciplines which require management of skeletal maturity. Examination of knee epiphyseal maturity correlates well with established maturity indicators at the hand wrist and may provide an alternate method of establishing skeletal maturity

Examination of knee epiphyseal maturity correlates well with established maturity indicators at the hand wrist and may provide an alternate method of establishing skeletal maturity.

Coyle, J, O'Connor, J, Spence, L, Last, J, A Comparative Investigation of Skeletal Maturity at the Knee and Hand-Wrist: Towards a Novel Diagnostic Tool.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007140.html