Estimating Skeletal Maturity Using Wrist Radiographs During Preadolescence: The Epiphyseal:Metaphyseal Ratio

Huang, Lauren F.; Furdock, Ryan; Uli, Naveen; Liu, Raymond W.

doi:10.1097/bpo.0000000000002174

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…For example, the modified Fels knee and wrist systems developed with a 90% FH standard have both been found to estimate skeletal maturity more accurately than GP. 16,17,22,23 Given the ease of use and presumed equivalence to PHV, our group has developed newer SMS based on the 90% FH standard, rather than PHV. However, the equivalence of 90% FH to PHV in developing an SMS has not been studied.…”

Section: Introductionmentioning

confidence: 99%

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Optimizing calibration of modern skeletal maturity systems

Furdock,

Moyal,

Benedick

et al. 2024

Journal of Children's Orthopaedics

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Purpose: Greulich and Pyle is the most used system to estimate skeletal maturity but has significant drawbacks, prompting the development of newer skeletal maturity systems, such as the modified Fels skeletal maturity systems based on knee radiographs. To create a new skeletal maturity system, an outcome variable, termed a “skeletal maturity standard,” must be selected for calibration of the system. Peak height velocity and 90% of final height are both considered reasonable skeletal maturity standards for skeletal maturity system development. We sought to answer two questions: (1) Does a skeletal maturity system developed using 90% of final height estimate skeletal age as well as it would if it was instead developed using peak height velocity? (2) Does a skeletal maturity system developed using 90% of final height perform as well in lower extremity length prediction as it would if it was instead developed using peak height velocity? Methods: The modified Fels knee skeletal maturity system was recalibrated based on 90% of final height and peak height velocity skeletal maturity standards. These models were applied to 133 serially obtained, peripubertal antero-posterior knee radiographs collected from 38 subjects. Each model was used to estimate the skeletal age of each radiograph. Skeletal age estimates were also used to predict each patient’s ultimate femoral and tibial length using the White–Menelaus method. Results: The skeletal maturity system calibrated with 90% of final height produced more accurate skeletal age estimates than the same skeletal maturity system calibrated with peak height velocity (p < 0.05). The 90% of final height and peak height velocity models made similar femoral and tibial length predictions (p > 0.05). Conclusion: Using the 90% of final height skeletal maturity standard allows for simpler skeletal maturity system development than peak height velocity with potentially more accuracy.

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Section: Introductionmentioning

confidence: 99%

“…For example, the modified Fels knee and wrist systems developed with a 90% FH standard have both been found to estimate skeletal maturity more accurately than GP. 16 , 17 , 22 , 23 …”

Section: Introductionmentioning

confidence: 99%

Optimizing calibration of modern skeletal maturity systems

Furdock,

Moyal,

Benedick

et al. 2024

Journal of Children's Orthopaedics

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Automated Distal Radius and Ulna Skeletal Maturity Grading from Hand Radiographs with an Attention Multi-Task Learning Method

Liu,

Wang,

Jiang

et al. 2024

Tomography

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Background: Assessment of skeletal maturity is a common clinical practice to investigate adolescent growth and endocrine disorders. The distal radius and ulna (DRU) maturity classification is a practical and easy-to-use scheme that was designed for adolescent idiopathic scoliosis clinical management and presents high sensitivity in predicting the growth peak and cessation among adolescents. However, time-consuming and error-prone manual assessment limits DRU in clinical application. Methods: In this study, we propose a multi-task learning framework with an attention mechanism for the joint segmentation and classification of the distal radius and ulna in hand X-ray images. The proposed framework consists of two sub-networks: an encoder–decoder structure with attention gates for segmentation and a slight convolutional network for classification. Results: With a transfer learning strategy, the proposed framework improved DRU segmentation and classification over the single task learning counterparts and previously reported methods, achieving an accuracy of 94.3% and 90.8% for radius and ulna maturity grading. Findings: Our automatic DRU assessment platform covers the whole process of growth acceleration and cessation during puberty. Upon incorporation into advanced scoliosis progression prognostic tools, clinical decision making will be potentially improved in the conservative and operative management of scoliosis patients.

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Estimating Skeletal Maturity Using Wrist Radiographs During Preadolescence: The Epiphyseal:Metaphyseal Ratio

Cited by 2 publications

References 21 publications

Optimizing calibration of modern skeletal maturity systems

Optimizing calibration of modern skeletal maturity systems

Automated Distal Radius and Ulna Skeletal Maturity Grading from Hand Radiographs with an Attention Multi-Task Learning Method

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