Assessment of Reliability of Greulich and Pyle (Gp) Method for Determination of Age of Children at Debre Markos Referral Hospital, East Gojjam Zone

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Addis Abeba University


Introduction: The significance of chronological age has gained salience in response to the development of laws and policies that rely on age as a marker or boundary. Skeletal age, or bone age, is the most common measure for biological maturation of the growing human. Greulich & Pyle and Tanner-Whitehouse (TW2) are the most prevalently employed skeletal age techniques today. However, the applicability of the Greulich & Pyle standards to populations which differ from their reference population is often questioned. Objectives: To assess reliability of Greulich and Pyle (GP) method for determination of age of children at Debre Markos referral hospital, East Gojjam Zone, Ethiopia. Subjects and methods: Hospital based cross sectional study design was applied to children coming to Debre Markos referral hospital from May to October 2015 GC who are fulfilling inclusion criteria of the study. The data was analyzed using SPSS version 20 and medcalc version 15 software. Significance was set at α= 0.05. Results: A total of 108 radiographs were analyzed. Mean skeletal age values are generally less than the corresponding chronological age. 64% of males and 63% of females sample CA were under estimated. The mean under-estimation was 11.8 months in the female sample and 8.7 months in the male sample. Although significant correlations were found to exist between SA and CA (p = .000), there was a significant difference between CA and SA (male, p = 0.0196; female, p = 0.0029). These differences occurred at 14, 19, 20, 21 and 22 years of age in females and 21 and 22 years of age in males.GP became inapplicable for the sample at 16 years for females and 16.5 years for males and later. Delay in skeletal maturation was observed in both sexes but the females in the sample are maturing earlier than the males. Conclusion: The findings of this study suggest against the applicability of GP atlas and may not be directly applicable to an East Gojjam zone population. Recommendation: Large scale researches should be planned and nationwide guideline and atlas which can easily be used throughout the country should be developed. Key words: chronological age, bone age, Greulich & Pyle



Chronological age, Bone age, Greulich & Pyle