Skeletal Age Determination in Young Children: Analysis of Three Regions of the Hand/wrist Film

The determination of skeletal age in young children is useful in predicting eventual leg length discrepancies, but underreading of skeletal age may result in predicting the ultimate leg length to be much longer than it actually will be, with a correspondingly larger discrepancy as well. We evaluated 100 hand/wrist radiographs of 45 children aged between 14 months and 9.8 years. Separate readings were taken of the distal radius and ulna, the carpal bones, and the metacarpals and phalanges. The discrepancy between bone ages and chronologic age was significantly different between regions of the hand and between sexes. When determining bone age in children under age 10 years, care should be taken to consider the entire hand, perhaps with less emphasis on the carpal bones.