ArticleJournal of the Chinese Medical Association : JCMA2023
Bone age assessment: Large-scale comparison of Greulich-Pyle method and Tanner-Whitehouse 3 method for Taiwanese children.
Article in Journal of the Chinese Medical Association : JCMA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Summation of ossification ratios of the distal radius, distal ulna, and proximal radius: a novel parameter for pediatric bone age assessment.Pediatric radiology · 2026Article
- Bone age assessment: comparative analysis of Greulich-Pyle and Tanner-Whitehouse 3 by pediatric radiologists and endocrinologists.BMC medical imaging · 2026Article
- Construction and Validation of a Simplified Bone Age Assessment Method Based on Three Key Bones from the TW3 system.Endocrine · 2026Article
- Inter-rater variability and repeatability in the assessment of the Tanner-Whitehouse classification of hand radiographs for the estimation of bone age.Skeletal radiology · 2024Article
- Body composition trajectories during childhood predict skeletal maturation at puberty: A longitudinal study.Heliyon · 2024Article
- Prediction of Fishman's skeletal maturity indicators using artificial intelligence.Scientific reports · 2023Article
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Authors and funding
3 authors.
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Abstract
backgroundThe Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW3) methods are two common methods for assessing bone age (BA). The applicability of these methods for populations other than those in the United States and Europe has been questioned. Thus, this study tested the applicability of these methods for Taiwanese children.
methodsIn total, 1476 radiographs (654 boys, 822 girls) were analyzed. A subset of 200 radiographs was evaluated to determine intrarater and interrater reliability and the time required to yield a BA assessment. BA was determined by two reviewers using the GP method and two of the TW3 methods (the Radial-Ulnar-Short bones [RUS] method and the carpals method [Carpal]). The GP and TW3 methods were directly compared using statistical techniques. A subgroup analysis by age was performed to compare BA and chronological age using a paired t test for each age group.
resultsThe average times required to yield an assessment using the GP and TW3-RUS methods were 0.79 ± 0.14 and 3.01 ± 0.84 min (p < 0.001), respectively. Both the intrarater and interrater correlation coefficients were higher for the GP method (0.993, 0.992) than the TW3-RUS (0.985, 0.984) and TW3-Carpal (0.981, 0.973) methods. The correlation coefficient for the GP and TW3-RUS methods was highest in the pubertal stage (0.898 for boys and 0.909 for girls). The mean absolute deviations for the GP and TW3-RUS methods in the pubertal stage were 0.468 years (boys) and 0.496 years (girls). Both the GP and TW3-Carpal methods underestimated BA for boys in the prepubertal stage. Both the GP and TW3-RUS methods overestimated BA for girls in the pubertal and postpubertal stages.
conclusionThe GP and TW3-RUS methods exhibit strong agreement in the pubertal and postpubertal stages for both sexes. With appropriate adjustments based on Taiwanese data, both methods are applicable to our children.
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