Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children

Background: There are several methods of bone age (BA) assessment, which include Gruelich-Pyle (GP), Gilsanz-Ratib (GR), and Tanner Whitehouse-3 (TW-3) methods. Although GP atlas is the most widely used, there are concerns about its accuracy in children of different ethnicities, making the use of th...

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Autores principales:	Nikhil Shah, Vaman Khadilkar, Nikhil Lohiya, Hemchand K Prasad, Prashant Patil, Ketan Gondhalekar, Anuradha Khadilkar
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	bone age children gilsanz-ratib gruelich-pyle india skeletal age tanner whitehouse tw-3 Diseases of the endocrine glands. Clinical endocrinology RC648-665 Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/fd71039b15034e76a2bc83e7ef6af5be
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spelling	oai:doaj.org-article:fd71039b15034e76a2bc83e7ef6af5be2021-11-12T10:10:55ZComparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children2230-821010.4103/ijem.IJEM_826_20https://doaj.org/article/fd71039b15034e76a2bc83e7ef6af5be2021-01-01T00:00:00Zhttp://www.ijem.in/article.asp?issn=2230-8210;year=2021;volume=25;issue=3;spage=240;epage=246;aulast=Shahhttps://doaj.org/toc/2230-8210Background: There are several methods of bone age (BA) assessment, which include Gruelich-Pyle (GP), Gilsanz-Ratib (GR), and Tanner Whitehouse-3 (TW-3) methods. Although GP atlas is the most widely used, there are concerns about its accuracy in children of different ethnicities, making the use of the TW-3 method an attractive option in Indian children. Objectives: 1) To assess the relationship of BA with chronological age (CA) as assessed by different methods (GP, GR, and TW-3) in healthy Indian children 2) To assess which of the three methods of BA assessment is more suitable in Indian children. Methodology: X-rays of 851 children (438 boys and 413 girls, aged 2–16.5 years) were analyzed by four independent observers using three different methods of BA estimation (GP, GR, and TW-3). Mean BAs were converted to Z-scores. For purpose of deciding which method of BA was most suitable in our cohort, a test of proportions and root mean square (RMS) deviations were computed. Results: Using the test of proportions, the TW-3 method was most suitable overall (P < 0.05). TW-3 method was again most applicable in prepubertal boys (P < 0.05), in prepubertal girls (although not significant, P > 0.1), and pubertal girls (P < 0.05). However, in pubertal boys, the GR atlas method was most suitable (P < 0.05). The same results were obtained when root mean square (RMS) deviations were computed. Interestingly, BA was underestimated in Indian boys irrespective of the method used. In Indian girls, however, the BA was underestimated till the pubertal growth spurt, after which there was rapid advancement of BA. Conclusions: Among the three methods (GP, GR, and TW-3), the BAs estimated by the TW-3 method were closest to CAs. Hence, it seems reasonable to recommend the use of the TW-3 method for BA estimation in the Indian population till an Indian standard bone age atlas is developed.Nikhil ShahVaman KhadilkarNikhil LohiyaHemchand K PrasadPrashant PatilKetan GondhalekarAnuradha KhadilkarWolters Kluwer Medknow Publicationsarticlebone agechildrengilsanz-ratibgruelich-pyleindiaskeletal agetanner whitehousetw-3Diseases of the endocrine glands. Clinical endocrinologyRC648-665Diseases of the digestive system. GastroenterologyRC799-869ENIndian Journal of Endocrinology and Metabolism, Vol 25, Iss 3, Pp 240-246 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bone age children gilsanz-ratib gruelich-pyle india skeletal age tanner whitehouse tw-3 Diseases of the endocrine glands. Clinical endocrinology RC648-665 Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	bone age children gilsanz-ratib gruelich-pyle india skeletal age tanner whitehouse tw-3 Diseases of the endocrine glands. Clinical endocrinology RC648-665 Diseases of the digestive system. Gastroenterology RC799-869 Nikhil Shah Vaman Khadilkar Nikhil Lohiya Hemchand K Prasad Prashant Patil Ketan Gondhalekar Anuradha Khadilkar Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children
description	Background: There are several methods of bone age (BA) assessment, which include Gruelich-Pyle (GP), Gilsanz-Ratib (GR), and Tanner Whitehouse-3 (TW-3) methods. Although GP atlas is the most widely used, there are concerns about its accuracy in children of different ethnicities, making the use of the TW-3 method an attractive option in Indian children. Objectives: 1) To assess the relationship of BA with chronological age (CA) as assessed by different methods (GP, GR, and TW-3) in healthy Indian children 2) To assess which of the three methods of BA assessment is more suitable in Indian children. Methodology: X-rays of 851 children (438 boys and 413 girls, aged 2–16.5 years) were analyzed by four independent observers using three different methods of BA estimation (GP, GR, and TW-3). Mean BAs were converted to Z-scores. For purpose of deciding which method of BA was most suitable in our cohort, a test of proportions and root mean square (RMS) deviations were computed. Results: Using the test of proportions, the TW-3 method was most suitable overall (P < 0.05). TW-3 method was again most applicable in prepubertal boys (P < 0.05), in prepubertal girls (although not significant, P > 0.1), and pubertal girls (P < 0.05). However, in pubertal boys, the GR atlas method was most suitable (P < 0.05). The same results were obtained when root mean square (RMS) deviations were computed. Interestingly, BA was underestimated in Indian boys irrespective of the method used. In Indian girls, however, the BA was underestimated till the pubertal growth spurt, after which there was rapid advancement of BA. Conclusions: Among the three methods (GP, GR, and TW-3), the BAs estimated by the TW-3 method were closest to CAs. Hence, it seems reasonable to recommend the use of the TW-3 method for BA estimation in the Indian population till an Indian standard bone age atlas is developed.
format	article
author	Nikhil Shah Vaman Khadilkar Nikhil Lohiya Hemchand K Prasad Prashant Patil Ketan Gondhalekar Anuradha Khadilkar
author_facet	Nikhil Shah Vaman Khadilkar Nikhil Lohiya Hemchand K Prasad Prashant Patil Ketan Gondhalekar Anuradha Khadilkar
author_sort	Nikhil Shah
title	Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children
title_short	Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children
title_full	Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children
title_fullStr	Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children
title_full_unstemmed	Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children
title_sort	comparison of bone age assessments by gruelich-pyle, gilsanz-ratib, and tanner whitehouse methods in healthy indian children
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/fd71039b15034e76a2bc83e7ef6af5be
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Comparison of bone age assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse methods in healthy Indian children

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