Evaluation of skeletal age based on Greulich-Pyle method in Tehran

Graphical abstract


Specifications
Medical physics. More specific subject area: Evaluation of skeletal age based on Greulich-Pyle method.
Type of data: Graph, table. Protocol name: Determining of skeletal age based on Greulich-Pyle. Experimental design: To compare bone age with chronological age, 40 children were randomly selected. After receiving informed consent from patients and their parents, radiograph of the left wrist and hand was taken.

Value of the Protocol
Determining of skeletal age based on Greulich-Pyle method, recognizing the differences in skeletal growth of Iranian children compared with GP method.

Protocol data
The data demonstrate that variations in skeletal growth in children aged 6-9.99 and 10-13.99 years old are greater than those evaluated by the Greulich and Pyle atlas, and that there are significant differences between bone and chronological ages. The categorizing groups based on BMD shows a great differences among our Mean AE SD chronological and bone ages in those male subjects who are underweight (BMD < 18.5) and obese (BMI ! 30). The Mean AE SD of difference of bone and chronological ages in male normal children (18.5 BMI 24.9) and overweight children (25 BMI 29.9) were 0.14 AE 0.55 and 0.87 AE 0.41 years, respectively. The Mean AE SD difference of chronological and bone ages in female subjects that are underweight, normal, and obese is À0.40 AE 2.69, 0.50 AE 0.49 and 0.45 AE 0.63, respectively. The variation in skeletal growth of Iranian children and children's group that the GP Atlas was taken could be related to environmental, economic, social, cultural and racial differences. Although this discrepancy is greater in boys than girls, so it may be affected by gender in Iran. Thus, GP Atlas could be more accurate to determine bone age in Iranian girls than boys.

Description of protocol
The Mean AE SD bone and chronological ages, weight, height and BMI of subjects based on gender are presented. Although the Mean AE SD BMI in boys was more than girls, the difference between Mean AE SD chronological and bone age in boys was lower than that of girls. The difference of Mean AE SD of chronological and bone ages in group 1 was more than other aged grouped (

Materials and methods
The aim of this methodology is to determine the differences between bone age and chronological age in Iranian children which could lead more accurate estimation of bone age. To compare bone age with chronological age, 40 children were randomly selected. Subjects aged between 2 and 18 years living in Tehran City, Iran. Exclusion criteria were history of systemic diseases more than 1 month, history of chronic systemic diseases, history of hospitalization for more than a week, and people with height or weight above the percentile of 97% or below 3 percent percentile. After receiving informed consent from patients and their parents, radiograph of the left wrist and hand was taken. Based on GP [5], all radiographs were reported by a radiologist who was of the patient's chronological age. These individuals were divided into four groups: 2-5.99, 6-9.99, 10-13.99 and 14-18 years old.

Statistical analysis
The normality of data was checked out by Shapiro-Wilk Test. For each group, mean AE SD of bone age, chronological age, weight, height and BMI (Body Mass Index) were determined; then data were analyzed using One-Sample T-Test by SPSS.

Conclusion
Although GP method is reliable and known method, there are some variations in skeletal growth of the Iranian children and children's group that the GP Atlas was taken that could be related to environmental, economic, social, cultural and racial differences. Since this discrepancy is greater in boys than girls, it may be affected by gender in Iran. Therefore, GP Atlas could be more accurate to determine bone age in Iranian girls than boys.