OBJECTIVE: To study the current development of hand-wrist bones of adolescents in China, and establish special forensic bony age standard for estimating 14 years of criminal responsible age in female adolescents. METHODS: One hundred and ten healthy girls aged from 13 years and 9 months to 14 years and 3 months in Lengshuijiang district of Hunan province were enrolled in this study. X-ray films of their left hand-wrists were taken dorsaventrally, and 15 sites on the wrist x-ray films were examined and measured under standard condition. The development grade was confirmed by maximal percentage to establish a method to estimate the bony age, which was then checked by single blind method. RESULTS: Development grade of the radius, the middle third phalanx and the fourth phalanx was partially closed (> 2/3), and the rest was wholly-closed with existence of the epiphyseal line. The development grade of the middle third phalanx and fourth phalanx was different between the younger group (< 14 years, partially closed, > 2/3) and the older group (> 14 years, mostly closed with existence of only epiphyseal line). The cross diameter of the osteoepiphysises were wider than that of all the diaphysises. The confirmed accuracy (in 30 girls) was 83.3%. CONCLUSION Our study seemes to be feasible in establishing the estimation standard for bony age determination. The standard established by developmental metaphysis and authropometry may be particularly helpful in forensic practice for estimation of accurate criminal responsible age in adolescents.
Adolescent ; Age Determination by Skeleton/methods* ; Epiphyses/diagnostic imaging* ; Female ; Forensic Anthropology/methods* ; Hand Bones/diagnostic imaging* ; Humans ; Radius/diagnostic imaging* ; Reference Standards ; Wrist/diagnostic imaging*

OBJECTIVE: To discuss the diagnostic value of English, Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty (CPP), then to confirm the normal thresholds. METHODS: Sixty one children as patient group were definitely assured CPP. The control group had 67 children. Among them, 61 were normal children, another 6 children as a special control group. Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method. The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0. RESULTS: (1) The skeletal age results showed kappa value is 0.776 deduced by two clinical doctors(u = 16.128, P < 0.05). (2) There were no statistic differences for the areas under ROC curves among three methods. (3) d > or = 1.15 years in TW2, d > or = 1.25 years in TW2-CHN and d > or = 0.65 years in TW2-JP were more susceptive and specific points. CONCLUSION TW2, TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children, and TW2-CHN is highest value for Chinese children.
Age Determination by Skeleton/standards* ; Age Factors ; Body Height ; Bone Development ; Carpal Bones/growth & development* ; Child ; Child, Preschool ; China ; Female ; Hand/growth & development* ; Humans ; Infant ; Male ; Puberty, Precocious/diagnosis* ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE: To compare three assessment methods (TW2, TW2CH, and TW3) for carpal bone age and their potential applications in diagnosis of idiopathic precocious puberty (IPP) in Chinese girls. METHODS: Fifty-five (55) girls with IPP and 83 normal girls as control group were selected in this study. The X-ray films of the left hand-wrist taken at their first visit were analyzed retrospectively. Three assessment methods were used to estimate the carpal bone age with single-blinded method and percentiles were set at 5 different decision thresholds (1)>97th percentile, (2)>90 th percentile, (3)>75th percentile, (4)>50 th percentile, and (5)< or =50th percentile. RESULTS: All of the three methods showed similar high sensitivity and specificity at the threshold above 90th percentile. CONCLUSION Our data indicate that all of the three methods for estimation of the carpal bone age are useful in diagnosis of IPP. TW2CH and TW3 methods appear to be superior to TW2 method.
Age Determination by Skeleton/standards* ; Algorithms ; Bone Development ; Carpal Bones/growth & development* ; Case-Control Studies ; Child ; Child Development ; Child, Preschool ; China ; Female ; Humans ; Puberty, Precocious/diagnosis* ; ROC Curve ; Retrospective Studies