J Korean Soc Pediatr Endocrinol.  2008 Jun;13(1):50-55.

Comparison of the Greulich-Pyle and Tanner Whitehouse (TW3) Methods in Bone Age Assessment

• Kim SY
• Oh YJ
• Shin JY
• Rhie YJ
• Lee KH

Abstract

PURPOSE: The determination of skeletal age is important for the analysis of growth and growth disorders in children. The aim of this study is to investigate the difference of bone age comparing Greulich-Pyle (GP) and Tanner Whitehouse (TW3) methods. We also evaluated the reproducibility of results of each method by different observers (interobserver variation) and by same observer (intraobserver variation).
METHODS
Bone ages were assessed from left hand-wrist radiographs of 200 children (108 males and 92 females) aged 7 to 15 years by GP and TW3 methods. To evaluate the reproducibility of each method, 102 radiographs were assessed independently by three observers and 100 radiographs were reassessed by one same observer using both methods.
RESULTS
The average bone age by GP and TW3 were 10.65+/-2.24 years and 10.48+/-2.18 years, respectively (P<0.01). There is significant correlation between GP and TW3 methods (R(2)=0.94, P<0.01). The interobserver variation of GP and TW3 was not different significantly (0.51+/-0.44 years by GP vs 0.54+/-0.42 years by TW3). The intraobserver variation also was not different significantly (0.48+/-0.44 years by GP vs 0.45+/-0.37 years by TW3).
CONCLUSION
Our data indicate that bone age by TW3 method was slightly younger than that by GP method but similar, and the reproducibility of both methods were not different. Therefore, both GP and TW3 methods are useful for estimation of bone age in Korea children.

Keyword

Greulich-Pyle method; Tanner-Whitehouse method; Bone age measurement; Reproducibility of results

MeSH Terms

Age Determination by Skeleton
Aged
Child
Growth Disorders
Humans
Korea
Male
Observer Variation
Reproducibility of Results