Tang Xin, Lu Yubo, Pang Mingfan, Nhan Derek T, Klyce Walter, Fritz Jan, Lee R Jay
Orthopedics. 2018 Sep 1;41(5):e676-e680. doi: 10.3928/01477447-20180724-03. Epub 2018 Jul 27.
Hand and wrist radiographs are the most common means for estimating skeletal bone age. There is no widely used scale for estimating skeletal bone age using knee radiographs. Do skeletal bone age estimates from knee-maturity scales correlate sufficiently with both chronologic age and estimates from a hand-wrist scale to potentially substitute for estimates from the latter? The authors reviewed the records of 503 patients 6 to 19 years old who had hand and knee radiographs obtained within 30 days of each other. They analyzed radiographs using the O'Connor knee scale (based on 10 maturation markers) and a new, abbreviated version of the O'Connor scale (based on 7 markers). The authors also analyzed radiographs of the hands of boys 12.5 to 16 years old and girls 10 to 16 years old using the shorthand method. Multivariate linear regression was used for analysis. Inter- and intrarater reliabilities were assessed. Skeletal bone age derived from the O'Connor and abbreviated knee scales correlated with chronologic age (adjusted R=0.88 and 0.90, respectively). Compared with estimates from the hand-wrist scale, estimates were lower by a mean of 0.91 years for boys and 0.38 years for girls when using the O'Connor scale and 0.96 years for boys and 0.52 years for girls when using the abbreviated scale. Inter- and intrarater reliabilities were very good (κ=0.82 and 0.90, respectively) and were substantial at each bony landmark measured. Knee radiographs can be used to estimate skeletal bone age using an abbreviated knee scale. [Orthopedics. 2018; 41(5):e676-e680.].
手部和腕部X光片是评估骨骼骨龄最常用的方法。目前尚无广泛应用的通过膝部X光片评估骨骼骨龄的标准。基于膝部成熟度标准评估的骨骼骨龄与实际年龄以及基于手部-腕部标准评估的结果之间的相关性是否足以替代后者呢？作者回顾了503例6至19岁患者的记录，这些患者在彼此30天内拍摄了手部和膝部X光片。他们使用奥康纳膝部标准（基于10个成熟标志物）和一个新的简化版奥康纳标准（基于7个标志物）分析X光片。作者还使用速记法分析了12.5至16岁男孩和10至16岁女孩的手部X光片。采用多变量线性回归进行分析，并评估了评估者间和评估者内的可靠性。源自奥康纳标准和简化膝部标准的骨骼骨龄与实际年龄相关（调整后的R分别为0.88和0.90）。与手部-腕部标准的评估结果相比，使用奥康纳标准时，男孩的评估结果平均低0.91岁，女孩低0.38岁；使用简化标准时，男孩低0.96岁，女孩低0.52岁。评估者间和评估者内的可靠性非常好（κ分别为0.82和0.90），并且在每个测量的骨标志处都很强。膝部X光片可用于使用简化膝部标准来估计骨骼骨龄。[《骨科》。2018年；41(5):e676 - e680。]
