Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa

Background: The Greulich–Pyle (GP) method is one of the most commonly used radiographic techniques for skeletal age (SA) determination. The applicability of this method for populations outside of the United States has been questioned and this has been investigated in several recent studies around th...

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Main Authors: Dashnee Govender, Matthew Goodier
Format: Article
Language:English
Published: AOSIS 2018-08-01
Series:South African Journal of Radiology
Subjects:
Online Access:https://sajr.org.za/index.php/sajr/article/view/1348
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author Dashnee Govender
Matthew Goodier
author_facet Dashnee Govender
Matthew Goodier
author_sort Dashnee Govender
collection DOAJ
description Background: The Greulich–Pyle (GP) method is one of the most commonly used radiographic techniques for skeletal age (SA) determination. The applicability of this method for populations outside of the United States has been questioned and this has been investigated in several recent studies around the world. Only limited data are available on the accuracy of the GP method for a South African population.   Objective: To determine the accuracy and reliability of the GP method in a population from KwaZulu-Natal, South Africa.   Method: A retrospective study was performed using a digital database consisting of 102 hand-wrist radiographs. The SA was estimated by two readers with different levels of experience, using the GP method. Differences between estimated SA and chronological age (CA) were analysed.   Results: Skeletal age determined with the GP method was found to significantly differ from CA. For the population as a whole, the GP method underestimated age. The greatest mean underestimation between SA and CA was 11.5 ± 17 months and 7.4 ± 13.2 months for the 10.1 to 15 year age groups in male and female patients, respectively. The method was found to have excellent inter- and intra-observer reliability.   Conclusion: The GP method generally significantly underestimates age for both genders. Overestimation is also possible with individuals as young as 16 years old found by the method to be skeletally mature. Until new SA assessment tools are developed for South Africa, use of supplementary means of determination of SA should be considered, especially in medico-legal cases.
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spelling doaj.art-f39cc101cf3a44d2bbe01135e53084982022-12-21T20:03:36ZengAOSISSouth African Journal of Radiology1027-202X2078-67782018-08-01221e1e610.4102/sajr.v22i1.1348911Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South AfricaDashnee Govender0Matthew Goodier1Department of Radiology, Grey’s Hospital, University of KwaZulu-NatalDepartment of Radiology, Grey’s Hospital, University of KwaZulu-NatalBackground: The Greulich–Pyle (GP) method is one of the most commonly used radiographic techniques for skeletal age (SA) determination. The applicability of this method for populations outside of the United States has been questioned and this has been investigated in several recent studies around the world. Only limited data are available on the accuracy of the GP method for a South African population.   Objective: To determine the accuracy and reliability of the GP method in a population from KwaZulu-Natal, South Africa.   Method: A retrospective study was performed using a digital database consisting of 102 hand-wrist radiographs. The SA was estimated by two readers with different levels of experience, using the GP method. Differences between estimated SA and chronological age (CA) were analysed.   Results: Skeletal age determined with the GP method was found to significantly differ from CA. For the population as a whole, the GP method underestimated age. The greatest mean underestimation between SA and CA was 11.5 ± 17 months and 7.4 ± 13.2 months for the 10.1 to 15 year age groups in male and female patients, respectively. The method was found to have excellent inter- and intra-observer reliability.   Conclusion: The GP method generally significantly underestimates age for both genders. Overestimation is also possible with individuals as young as 16 years old found by the method to be skeletally mature. Until new SA assessment tools are developed for South Africa, use of supplementary means of determination of SA should be considered, especially in medico-legal cases.https://sajr.org.za/index.php/sajr/article/view/1348skeletal agegreulich and pyle Methodgreulich and pyle atlas
spellingShingle Dashnee Govender
Matthew Goodier
Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa
South African Journal of Radiology
skeletal age
greulich and pyle Method
greulich and pyle atlas
title Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa
title_full Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa
title_fullStr Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa
title_full_unstemmed Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa
title_short Bone of contention: The applicability of the Greulich–Pyle method for skeletal age assessment in South Africa
title_sort bone of contention the applicability of the greulich pyle method for skeletal age assessment in south africa
topic skeletal age
greulich and pyle Method
greulich and pyle atlas
url https://sajr.org.za/index.php/sajr/article/view/1348
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