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Forensic use of the Greulich and Pyle atlas: prediction intervals and relevance

  • Forensic Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

The Greulich and Pyle (GP) atlas is one of the most frequently used methods of bone age (BA) estimation. Our aim is to assess its accuracy and to calculate the prediction intervals at 95% for forensic use.

Methods

The study was conducted on a multi-ethnic sample of 2614 individuals (1423 boys and 1191 girls) referred to the university hospital of Marseille (France) for simple injuries. Hand radiographs were analysed using the GP atlas. Reliability of GP atlas and agreement between BA and chronological age (CA) were assessed and prediction intervals at 95% were calculated.

Results

The repeatability was excellent and the reproducibility was good. Pearson’s linear correlation coefficient between CA and BA was 0.983. The mean difference between BA and CA was -0.18 years (boys) and 0.06 years (girls). The prediction interval at 95% for CA was given for each GP category and ranged between 1.2 and more than 4.5 years.

Conclusion

The GP atlas is a reproducible and repeatable method that is still accurate for the present population, with a high correlation between BA and CA. The prediction intervals at 95% are wide, reflecting individual variability, and should be known when the method is used in forensic cases.

Key Points

• The GP atlas is still accurate at the present time.

• There is a high correlation between bone age and chronological age.

• Individual variability must be known when GP is used in forensic cases.

• Prediction intervals (95%) are large; around 4 years after 10 year olds.

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Abbreviations

BA:

Bone age

CA:

Chronological age

GP:

Greulich and Pyle atlas

TW:

Tanner and Whitehouse method

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Acknowledgments

The scientific guarantor of this publication is K Chaumoitre, MD, PHD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise (B Saliba-Serre). This work has been approved by the Public Advisory Committee (reference number RO – 2015/22). Written informed consent was not required for this study because it concerns anonymised normal X-rays. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Medical Imaging, APHM, Hôpital Nord, Chemin des Bourrellys, 13015, Marseille, France

    K. Chaumoitre & M. Panuel

  2. UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Faculté de Médecine de Marseille, 51 boulevard Pierre Dramard, 13344, Marseille Cedex 15, France

    K. Chaumoitre, B. Saliba-Serre, P. Adalian, M. Signoli, G. Leonetti & M. Panuel

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  1. K. Chaumoitre
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Correspondence to K. Chaumoitre.

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Chaumoitre, K., Saliba-Serre, B., Adalian, P. et al. Forensic use of the Greulich and Pyle atlas: prediction intervals and relevance. Eur Radiol 27, 1032–1043 (2017). https://doi.org/10.1007/s00330-016-4466-4

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  • DOI: https://doi.org/10.1007/s00330-016-4466-4

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