Avis de l’ESPR : "Bone age for chronological age determination. Recommendation from the ESPR musculoskeletal task force group"

Source : ESPR

Date : Novembre 2018

Extraits :

« 1. There is a clear correlation between chronological age and skeletal maturation.

2. The Greulich and Pyle atlas is still valid, however most relevant data cover populations from a relatively limited geographic area.

3. All studies show that the exact chronological age cannot be determined based on a person’s bone age. It is impossible to determine whether a person is over or under 18 years based on bone age of the hand/wrist.

4. It is not possible to overcome the biological variation, hence the 95% prediction interval for chronological age is wide for each bone age developmental stage. The study with the most robust design (Chaumoitre 2017) shows that the prediction interval is a minimum 4-6 years.

5. There is no/sparse literature on the additional effect of malnutrition/stress/ health related issues that can increase the chronological age reference-interval calculated from bone age.

6. Using correct mathematical models, it may be possible to calculate statistical probabilities for a chronological age range for each skeletal maturation stage on a group basis, assuming that the data on which such a model is based is representative of all ethnicities and takes influences of nutrition and medical conditions for skeletal variation into account, which to date is not feasible. Furthermore, since there is no end-point of chronological age after full skeletal maturation, such a mathematical model will also have to define the upper possible chronological age for the population on which the method is applied, which is a paradox since the chronological age is unknown.  »

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