Ziele: Die Bestimmung des Knochenalters ist bei Kindern wichtig, insbesondere bei Patienten mit Wachstumsproblemen und chronischen Erkrankungen. Eine Standardmethode ist die Bestimmung des Knochenalters nach Greulich und Pyle anhand von Röntgenaufnahmen der linken Hand. Ziel unserer Studie war es, die Genauigkeit einer neuen, auf Ultraschall-Messung basierenden Methode im Vergleich zur Standard-Methode zu prüfen. Methode: 70 konsekutiv ausgewählte Patienten (kalendarisches Alter zwischen 6 und 17 Jahre, 34 Mädchen, 36 Knaben), die zur Bestimmung des Knochenalters eine Röntgen-Aufnahme der linken Hand erhalten hatten, wurden in die Studie eingeschlossen. Ein Kinderradiologe analysierte das Knochenalter für die gesamte linke Hand und für den distalen Radius anhand des Atlas von Greulich und Pyle ohne Kenntnis des Ergebnisses der Ultraschall-Messung und ohne Kenntnis über das kalendarische Alter des Kindes. Die Ultraschall-Messung wurde am selben Tag durchgeführt unter Verwendung des BonAge-Systems (Sunlight Med. Ltd., Israel). Das System evaluiert die Beziehung zwischen der Ausbreitungsgeschwindigkeit der Ultraschallwelle (Speed of Sound) und dem Wachstum unter Verwendung eines geschlechts-basierten Algorithmus. Ergebnis: Die sonographische Messung war bei 5 Kindern nicht erfolgreich (Grund: Bewegungsunruhe). Bei 65 Kindern war die Messung durchführbar. Der Korrelationskoeffizient nach Pearson (r2) zwischen sonographischem und röntgenologischem Messergebnis war bei 0,82. Die absoluten Differenzen in Jahren zwischen den beiden Methoden lagen bei 1,0 +/- 0,8 Jahren für die gesamte linke Hand und bei 0,8 +/- 0,7 Jahren für den distalen Radius. Im Mittel war die Differenz zwischen BonAge und röntgenologischer Methode mit ca. 1,4 Jahren gleich. Schlussfolgerung: Unsere Studie konnte zeigen, dass mit der BonAge-Methode eine relativ genaue Bestimmung des Knochenalters sonographisch möglich ist.

Purpose: Determination of skeletal development in children is important. The most used evaluation method is to study left hand X-ray based on the standards depicted by Greulich & Pyle. The aim of our study was to compare the accuracy of a new sonographically based method with the standard method. Material and Methods: 160 consecutive evaluated children and adolescents (77 male, 83 female) who received a X-ray of the left hand were evaluated. Ultrasound examination of the same hand was performed on the same day using the BonAge (TM) system (Sunlight Medical Ltd., Israel). This system evaluates the relationship between the velocity of the wave (speed of sound) passing thorough the distal radial and ulna epiphysis and growth, using gender- and ethnicity-based algorithms. Three experienced investigators (U1-U3) analysed the X-ray and assigned bone age scores based on the Greulich & Pyle atlas (G&P). The investigators were blinded to the calendary age (CA) of the patient and also for the BonAge (TM) result. Correlation between BonAge system results and G&P was performed using SPSS 12.0.1. Results: In 152 patients BonAge (TM) measurement could be performed successfully. The correlation between the three investigators using the G&P method was between 0.977 and 0.980; correlation between the BonAge system and the investigators (U1-U3) was 0.902 and 0.920. The paired t-test showed no significant differences between the BonAge system and the three investigators and also for the comparison between U1 and U2. There were significant differences between U1 vs. U3 and U2 vs. U3 (p < 0.05). Discussion: The BonAge (TM) device demonstrates the ability to produce an sufficient assessment of bone age using an ultrasound method. The results are correlated with conventional skeletal age evaluation using the G&P method. Advantages of the ultrasound device are objectivity, lack of ionizing radiation, and easy accessibility. In the case of first investigation Xray is necessary to look for dissociated skeletal age, dysplasia, and mineralisation.

PURPOSE:Determination of skeletal development in children is important. The most used evaluation method is to study left hand X-ray based on the standards depicted by Greulich and Pyle. The aim of our study was to compare the accuracy of a new sonographically based method with the standard method.MATERIAL AND METHODS:160 consecutive evaluated children and adolescents (77 male, 83 female) who received a X-ray of the left hand were evaluated. Ultrasound examination of the same hand was performed on the same day using the BonAge system (Sunlight Medical Ltd., Israel). This system evaluates the relationship between the velocity of the wave (speed of sound) passing thorough the distal radial and ulna epiphysis and growth, using gender- and ethnicity-based algorithms. Three experienced investigators (U1-U3) analysed the X-ray and assigned bone age scores based on the Greulich and Pyle atlas (G and P). The investigators were blinded to the calendary age (CA) of the patient and also for the BonAge result. Correlation between BonAge system results and G and P was performed using SPSS 12.0.1.RESULTS:In 152 patients BonAge measurement could be performed successfully. The correlation between the three investigators using the G and P method was between 0.977 and 0.980; correlation between the BonAge system and the investigators (U1-U3) was 0.902 and 0.920. The paired t-test showed no significant differences between the BonAge system and the three investigators and also for the comparison between U1 and U2. There were significant differences between U1 vs. U3 and U2 vs. U3 (p < 0.05).DISCUSSION:The BonAge device demonstrates the ability to produce an sufficient assessment of bone age using an ultrasound method. The results are correlated with conventional skeletal age evaluation using the G and P method. Advantages of the ultrasound device are objectivity, lack of ionizing radiation, and easy accessibility. In the case of first investigation X-ray is necessary to look for dissociated skeletal age, dysplasia, and mineralisation.

Background: Determination of skeletal development in children is important. The most common method of evaluation uses the standards of Greulich and Pyle (G&P) to assess the left hand radiograph. Numerous assessments may be made during follow-up. Objective: The aim of our study was to compare the accuracy of a new sonographic method with the standard radiographic method. Materials and methods: Seventy consecutive patients (age 6–17 years; 34 girls, 36 boys) underwent radiography of the left hand, followed by sonographic examination of the same hand using the BonAge system (Sunlight Medical Ltd., Israel). This system evaluates the relationship between the velocity of sound passing thorough the distal radial and ulna epiphysis and growth, using gender- and ethnicity-based algorithms. One experienced paediatric radiologist analysed the radiograph and assigned bone age scores based on the G&P atlas for the whole left hand and for the distal radius alone. The radiologist was blinded to the chronological age (CA), height of the patient and the BonAge result. Correlation between BonAge and G&P was undertaken. Results: In 65 patients, BonAge measurement could be performed successfully. In five patients, the scanning process was impossible using the ultrasound device. The r2 (r is the Pearson correlation coefficient) of the BonAge ultrasound measurement and the G&P method was 0.82. The averaged accuracy (i.e. absolute difference in years between G&P reading and BonAge ultrasonic results) was calculated. Results were similar for boys and girls: 1.0±0.8 years for the whole left hand and 0.8±0.7 year for the distal radius. On average, the difference between BonAge and CA is the same as the difference between G&P and CA, i.e. 1.4 years. Conclusions: The BonAge device demonstrates the ability of ultrasound to produce an accurate assessment of bone age. The results are highly correlated with skeletal age evaluated conventionally using the G&P method. Obvious advantages of the ultrasound device are objectivity, lack of ionizing radiation, and easy accessibility.