Determination of Bone Age and its Correlation to the Chronological Age Based on the Greulich and Pyle Method in Saudi Arabia

Introduction: Many clinical indications need the measurement of bone age, including growth and development abnormalities, the timing of corrective procedures in pediatric patients, and the assessment and treatment of specific endocrine conditions. These evaluations are also useful in forensic science.

Aim: This study aims to compare the bone age of children aged 4 to 18 years old with their chronological age in order to determine whether the Greulich-Pyle (GP) method is trustworthy for Saudi youngsters.

Materials & Methods: Multiple approaches for determining bone age have been published, but Greulich and Pyle's methodology is the most extensively utilized. This method is based on an inspectional evaluation that compares the radiograph to the pattern described in a 1950 atlas using a sample of North American children aged birth to 18 years for the female sex and up to 19 years for the male sex. It is one of the most commonly utilized procedures for assessing the skeletal age of children and adolescents since it is rapid and quick to perform. It is based on the fact that ossification centers in the hand and wrist bones emerge in a predetermined order. For male and female youngsters, the degree of ossification in various hand and wrist bones is compared to the nearest matching plate on the Greulich & Pyle Atlas. This cross-sectional study was performed during April 2021 to September 2021.

Results: Total 216 patients were included or selected in this study among age group 4-18 years, the sex distribution among them were 148 (68.5%) and 68 (31.5%) were male and female respectively. Chronological age and bone age assessment by GP methodamong doctors when chronological age was 135.2 ± 45.0 (range, 45-216 months). Chronological age in male and female were 143.5 ± 44.0 and 116.9 ± 41.8 respectively with p value <0.001 which was statistically significant. The bone age were observed in two reading, first reading and second reading after 15 days by two doctors separately and all the finding were recorded almost similar and significant with p value <0.001. Correlation between Chronological age and Bone age by GP method in both sex observed significant p value <0.001. Linear regression analysis showed that the bone ageand its correlation to the chronological age assessment in first reading in male(r=0.761 and p<0.001) and female(r=0.889 and p<0.001), in reading after 15 days in male(r=0.760 and p<0.001) and female(r=0.868 and p<0.001).

Conclusion: In order to evaluate whether the Greulich-Pyle (GP) technique is accurate for Saudi children, the bone age of children aged 4 to 18 years old should be evaluated to their chronological age, according to this research.