Cundall D B, Brocklebank J T, Buckler J M
Department of Paediatrics, St James's University Hospital, Leeds, UK.
Pediatr Nephrol. 1988 Apr;2(2):200-4. doi: 10.1007/BF00862591.
One hundred radiographs of the left hand and wrist from 40 children with chronic renal insufficiency or end-stage renal disease were examined to determine which method of bone age estimation provided the most useful information in these children. The Tanner and Whitehouse method showed better repeatability than the Greulich and Pyle atlas or the Buckler handbook when a sample of the radiographs were assessed twice by the same observer. The Tanner and Whitehouse 20 (TW20) bone age showed less inter-observer bias than the radius, ulna and short bone age or the carpal bone age when three observers independently assessed the same sample of radiographs. TW20 was the most useful method of bone age assessment in this study of British children. An unexpected finding was that the carpal bones were significantly more retarded than the radius, ulna and short bones. Separate assessment of the carpal bone age may provide extra information of clinical relevance.
对40名患有慢性肾功能不全或终末期肾病儿童的100张左手和腕部X光片进行了检查，以确定哪种骨龄评估方法能为这些儿童提供最有用的信息。当同一名观察者对一部分X光片样本进行两次评估时，坦纳和怀特豪斯方法显示出比格罗利希和派尔图谱或巴克尔手册更好的重复性。当三名观察者独立评估相同的X光片样本时，坦纳和怀特豪斯20（TW20）骨龄显示出比桡骨、尺骨和短骨龄或腕骨龄更小的观察者间偏差。在这项针对英国儿童的研究中，TW20是最有用的骨龄评估方法。一个意外发现是，腕骨比桡骨、尺骨和短骨明显更滞后。单独评估腕骨龄可能会提供具有临床相关性的额外信息。
