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Clinical application value of musculoskeletal ultrasound in assessing bone age in children

orthopedics
pediatrics
radiology-and-medical-imaging

Abstract

Background: Ultrasonography offers several advantages in medical diagnostics, including the absence of radiation exposure, convenience, and real-time dynamic imaging. In this study, we used radiographic bone age assessment based on left-hand wrist X-rays as the diagnostic standard to evaluate the clinical utility of ultrasound in bone age estimation.

Methods: This study enrolled children from a large tertiary hospital who underwent a left-hand radiograph for bone age assessment. Within one week of the X-ray, each child also received an ultrasound scan of the left wrist, metacarpophalangeal, and knee. We calculated the ossification ratio (length of the ossification center/length of the epiphysis) and the skeletal maturity score (SMS) for each bone. Finally, we analyzed the correlation of these ultrasound-based measures with the radiographic bone age.

Results: Ultrasound imaging clearly visualized the ossification centers and epiphyseal cartilage. Radiographic bone age showed a correlation with the SMS of the metacarpals, phalanges, ulna, radius, and femur, with the strongest correlation observed between radiographic bone age and the combined SMS of the ulna, radius, and femur.

Discussion: Ultrasound demonstrates efficacy as a feasible examination method for assessing pediatric bone age, showing potential to emerge as a novel diagnostic tool for this application.

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