TY - JOUR
T1 - Greater Trochanter Height
T2 - A Quantitative Predictor of Skeletal Maturity
AU - Nelson, Grant
AU - Knapik, Derrick M.
AU - Janes, Jessica L.
AU - Liu, Raymond W.
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background:The purpose of this investigation was to develop a quantitative and reproductible method for estimating skeletal maturity based on measurements of the height of the bony greater trochanter (GT) using timing to 90% of final height as a gold standard.Methods:Bony GT height was measured using serial anteroposterior pelvic radiographs in 76 healthy pediatric patients obtained from the Bolton-Brush (BB) Study with corresponding Greulich-Pyle (GP) bone ages. Chronologic age at 90% of final height was calculated. GT height was then measured in 300 contemporary patients aged 4 to 18 years, evenly divided based on sex and race. Bony GT height was compared between BB and contemporary patients, while linear mixed-effects models were used to examine for potential predictors of years to 90% final height using patient sex, GP bone age and bony GT height measurements.Results:Bony GT height was measured in 303 radiographs from the BB Collection (n=37 males; n=39 females) with corresponding GP bone ages, chronological ages, and heights to represent skeletal maturity. Mean age at 90% final height was 13.3±0.6 years for males and 11.4±0.8 years for females. When controlling for patient age and sex, multiple regression analysis revealed that contemporary patients possessed significantly greater bony GT height (mean difference: 1.15 mm; P=0.001) when compared with BB patients. Multivariate analysis showed that combining bony GT height, GP bone age, and sex significantly predicted years to 90% total growth (P<0.001) and explained ∼85% (95% confidence interval for R2: 82%-87%) of the total variance in years using 90% of final height, with sex, GP bone age, and GT height all significant contributors.Conclusions:Including bony GT height provides more accurate prediction of 90% final height when combined with GP bone age and sex. GT height offers an efficient and accurate parameter that may be utilized in pediatric orthopedic conditions requiring a quantitative estimate of bone age in children with prior pelvis or hip imaging.Level of Evidence:Level II - diagnostic study.
AB - Background:The purpose of this investigation was to develop a quantitative and reproductible method for estimating skeletal maturity based on measurements of the height of the bony greater trochanter (GT) using timing to 90% of final height as a gold standard.Methods:Bony GT height was measured using serial anteroposterior pelvic radiographs in 76 healthy pediatric patients obtained from the Bolton-Brush (BB) Study with corresponding Greulich-Pyle (GP) bone ages. Chronologic age at 90% of final height was calculated. GT height was then measured in 300 contemporary patients aged 4 to 18 years, evenly divided based on sex and race. Bony GT height was compared between BB and contemporary patients, while linear mixed-effects models were used to examine for potential predictors of years to 90% final height using patient sex, GP bone age and bony GT height measurements.Results:Bony GT height was measured in 303 radiographs from the BB Collection (n=37 males; n=39 females) with corresponding GP bone ages, chronological ages, and heights to represent skeletal maturity. Mean age at 90% final height was 13.3±0.6 years for males and 11.4±0.8 years for females. When controlling for patient age and sex, multiple regression analysis revealed that contemporary patients possessed significantly greater bony GT height (mean difference: 1.15 mm; P=0.001) when compared with BB patients. Multivariate analysis showed that combining bony GT height, GP bone age, and sex significantly predicted years to 90% total growth (P<0.001) and explained ∼85% (95% confidence interval for R2: 82%-87%) of the total variance in years using 90% of final height, with sex, GP bone age, and GT height all significant contributors.Conclusions:Including bony GT height provides more accurate prediction of 90% final height when combined with GP bone age and sex. GT height offers an efficient and accurate parameter that may be utilized in pediatric orthopedic conditions requiring a quantitative estimate of bone age in children with prior pelvis or hip imaging.Level of Evidence:Level II - diagnostic study.
KW - bone age
KW - greater trochanter
KW - growth
KW - height
KW - radiographs
KW - skeletal maturity
UR - http://www.scopus.com/inward/record.url?scp=85099794928&partnerID=8YFLogxK
U2 - 10.1097/BPO.0000000000001724
DO - 10.1097/BPO.0000000000001724
M3 - Article
C2 - 33284139
AN - SCOPUS:85099794928
SN - 0271-6798
VL - 41
SP - 99
EP - 104
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 2
ER -