Bone Abstracts

Background: To assess the effect of secular change on skeletal maturation and thus on the applicability Tanner and Whitehouse (TW3) methods of bone age estimation.

Methods: A single observer assessed bone age using BoneXpert software on 392 hand/wrist trauma radiographs (206 males, 257 left, age range 2 to 15 years, 296 Caucasians, 71 Asians, 20 Africans, 5 mixed Caucasian and Asian) performed in the period 2010–2016. The paired sample t test was used to indicate the difference between mean bone age (BA) and mean chronological age (CA). ANOVA was used to assess the differences between groups based on socioeconomic status (taken from the index of multiple deprivation). The standard error of the estimate (SEE, in ± years) for both sexes was calculated.

Results: Chronological age ranged from 2 to 15 years for females and 2.5 to 15 years for males. Numbers of children living in low, average and high socioeconomic areas were 216 (55%), 74 (19%) and 102 (26%) respectively. The TW3 BA was underestimated in females compared to chronological age beyond the age of 3 years, with significant differences between BA and CA (−0.43 years ±1.05 P=<0.001) but not in males (0.01 years SD 0.97, P=0.76). Of the difference in females, 17.8% was accounted for by socioeconomic status. Despite the statistically significant observed difference between BA and CA, the TW3 showed comparable accuracy in females and males with SEE of ±1.06 and ±1.00 years, respectively.

Conclusion: Secular change has not advanced skeletal maturity of present-day UK children compared to those of the mid-20th century.

Disclosure: The authors declared no competing interests.