New Method of Assessment of Bone Age "TW3" and First Results of its Application in the Czech Republic
Abstract
The authors processed by statistical methods a representative group of roentgenograms of the hand and the distal part of the forearm by three, at present most accurate known methods for the evaluation of bone age, i.e. the GP, TW2 and TW3 methods. Based on the results of their investigation and consistent with the contents of the TW3 method published this year, the authors recommend to abandon in the practice of specialized departments the hitherto used TW2 method.
For exact evaluation of the bone age they recommend the method TW3 which due to quite recent standards of ossification of the skeleton of the hand and the distal part of the forearm reflects the influence of the secular trend on the earlier biological maturity of contemporary European children and pubescents. According to the results of the investigation and hitherto assembled experience of the authors with the TW3 method the values assessed for compartments RUS (radius, ulna, metacapri, and phalanges) correnspond to the degree of maturity of the gonads and the maturity of the carpal compartment of the hand of contemporary boys and girls better than values assessed by the TW2 method.
The differences of results of methods TW2 and TW3 are on average one year which is from the clinical aspect a very significant difference (lower values in TW3). The authors also proved an approximate agreement of values of bone age assessed by GP and TW3 methods.
Based on this finding they recommend to use the GP method in common "statim" practice where an accurate check of the ossification rate or treatment resp. are not required. The mentioned findings apply to age groups above nine years.
Standards of the TW3 method for younger children are identical with TW2, data of younger subjects were therefore not tested in the present work.