Assessment of skeletal age in youth female soccer players: Agreement between Greulich‐Pyle and Fels protocols

Abstract

The purpose of the study was to evaluate the agreement between the Fels and Greulich-Pyle methods for the assessment of skeletal age (SA) in female youth soccer players. Methods:The sample included 441 Portuguese players 10.08-16.73 years of age who regularly participated in organized and competitive soccer. Standardized radiographs of the left hand-wrist were obtained and analyzed by an experienced examiner. SA was estimated with the Fels and Greulich-Pyle (GP) methods. Differences between SA and chronological age (CA) were used to define skeletal maturity groups: late, average and early maturing. In addition to descriptive statistics, Cohen's kappa and Lin concordance correlation coefficients were used to evaluate agreement between methods. Results: Intraindividual differences in SA based on the two methods varied between 0.10 to 1.47 years among age groups with larger mean differences at older ages. Agreement of maturity classifications between methods was 74% at younger ages (under-13: kappa = 0.48; under-14: kappa = 0.39; Lin CCC = 0.68) and declined with increasing CA (under-17: 19% agreement; kappa = 0.001; Lin CCC = 0.11). About 19% of the total sample was skeletally mature with the Fels method and an SA was not assigned; in contrast, no players were skeletally mature with the GP method. Conclusions: GP SAs were systematically lower than Fels SAs among female soccer players. Intraindividual variability in SAs between methods was considerable. The findings highlight the impact of method on estimates of maturity status.

Prediction of maturity offset and age at peak height velocity in a longitudinal series of boys and girls

“…A similar trend for later maturation is also suggested among female distance runners, though data are not extensive (Malina, 2011). Skeletal maturity data for female participants in team sports are lacking, but a recent study of female soccer players showed a tendency for SA to be in advance of CA, on average, at 12 to 14 years, allowing for variation between the Greulich-Pyle and Fels methods of assessment (Martinho et al, 2020).…”

Precision and Accuracy of Radiological Bone Age Assessment in Children among Different Ethnic Groups: A Systematic Review

“…In addition, 16 of the included studies were conducted in Europe, accounting for 31.37% of the total. Specifically, there were three studies in the United Kingdom [55][56][57], two in Spain [58,59], two in Portugal [60,61], two in Italy [62,63], two in France [64,65], one in Austria [66], one in Germany [67], one in the Netherlands [68,69], one in Sweden [69], and one conducted in Denmark [70].…”

“…Regarding study design, 25 (49.02%) were observational retrospective cohort studies [23,35,40,42,43,48,50,52,54,55,57,58,[61][62][63][64][65][66][67][68][69]76,79,83,84], followed by 19 (37.25%) crosssectional studies [30,[36][37][38][44][45][46]51,53,59,60,[72][73][74][75]77,78,81,82], and 7 (13.73%) observational prospective cohort studies [39,41,55,56,70,71,80].…”

“…Additionally, five studies (9.80%) were conducted exclusively in Africa, including two in South Africa [71,72], one in Zimbabwe [73] one in Botswana [74], and one in A total of 30 papers (58.8%) studied the accuracy [23,[35][36][37]40,41,43,45,48,49,[51][52][53]55,57,59,[64][65][66]69,70,[72][73][74][76][77][78][79][80]82], 1 of which also separately calculated the sensitivity and specificity [62]. A total of 27 (52.94%) studies analyzed precision [35,36,42,44,46,47,50,52,[56][57][58][60][61][62]…”

Intra-observer reproducibility and inter-observer agreement of Fels skeletal age assessments among male tennis players 8–16 years

“…Biological maturation is a process marking progress toward the biologically mature or adult state. Although assessments of skeletal age (SA) based on the bones of the hand and wrist are generally used in a clinical context, SA is also a commonly used indicator of maturity status in studies of youth athletes [ 1 , 2 ]. An assigned SA is the chronological age (CA) at which specific stages of maturity of the hand-wrist bones are attained relative to the reference sample upon which the method of assessment was developed.…”