OBJECTIVE: To study the bone development in adolescents in China, and establish forensic skeletal age standard for estimation of the criminal responsible age in 14 years old male adolescents. METHODS: One hundred and three healthy boys aged from 13 years and 9 months to 14 years and 3 months in Lengshuijiang, Hunan, China were enrolled in this study. X-ray films of their left hand-wrist were taken dorsaventrally, and 15 selected sites on the wrist X-ray films were examined and measured under standard condition. The development grade was confirmed by maximum percentage to establish a method to estimate the bone age, which was then checked by single blind method. RESULTS: Development grade of the first metacarpal bone and the first phalanx IV was partially closed (less than 1/3), but the rest was non-closed. The cross diameters of all the osteoepiphysis were wider than that of all the diaphysis. The development grade of the fourth metacarpal bone and the fifth metacarpal bone as well as the adjacent third phalanx were different in both younger age group (<14 years, mostly non-closed) and the older age group (>14 years, mostly closed). The confirmed accuracy (in 30 boys) was 80%. CONCLUSION Our study seems to be feasible in establishing the estimation standard for skeletal age determination using developmental metaphysis and anthropometry. The standard may be particularly helpful in forensic practice for estimation of accurate criminal responsible age in adolescents.
Adolescent ; Age Determination by Skeleton/methods* ; Anthropometry/methods* ; Bone Development/physiology* ; Carpal Bones/growth & development* ; Forensic Anthropology/methods* ; Hand Bones/growth & development* ; Humans ; Male ; Metacarpal Bones/growth & development* ; Reference Values

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