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Skeletal Age and Age Verification in Youth Sport

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Abstract

Problems with accurate chronological age (CA) reporting occur on a more or less regular basis in youth sports. As a result, there is increasing discussion of age verification. Use of ‘bone age’ or skeletal age (SA) for the purpose of estimating or verifying CA has been used in medicolegal contexts for many years and also in youth sport competitions. This article reviews the concept of SA, and the three most commonly used methods of assessment. Variation in SA within CA groups among male soccer players and female artistic gymnasts is evaluated relative to the use of SA as a tool for verification of CA. Corresponding data for athletes in several other sports are also summarized. Among adolescent males, a significant number of athletes will be identified as older than a CA cutoff because of advanced skeletal maturation when they in fact have a valid CA. SA assessments of soccer players are comparable to MRI assessments of epiphyseal-diaphyseal union of the distal radius in under-17 soccer players. Both protocols indicate a relatively large number of false negatives among youth players aged 15–17 years. Among adolescent females, a significant number of age-eligible artistic gymnasts will be identified as younger than the CA cutoff because of later skeletal maturation when in fact they have a valid CA. There is also the possibility of false positives-identifying gymnasts as younger than the CA cutoff because of late skeletal maturation when they have a valid CA. The risk of false negatives and false positives implies that SA is not a valid indicator of CA.

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Acknowledgements

No funding supported this review and the author has no conflicts of interest that are directly relevant to the content of this review. The suggestions of W.C. Chumlea are recognized and greatly appreciated as are those of the anonymous reviewers. Most of the raw data used in this review was shared with the author by colleagues: Manuel Coelho e Silva and Antonio Figueiredo (Universidade de Coimbra, Portugal), Luis Horta (Centro de Estudos de Exercício e Saúde, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal), Manuel Chamorro and Luis Serratosa (Servicios Medicos Sanitas-Real Madrid, Madrid, Spain), Christopher Carling (Lille Métropole Football Club, Domain de Luchin, Camphin-en-Pévèle, France and Institute of Coaching and Performance, University of Central Lancashire, Preston, UK), Maria Eugenia Peña Reyes (Instituto Nacional de Antropologia e Historia, Distrito Federal, México), Betty Perez Mendez (Universidad Central de Venezuela, Caracas), Gaston Beunen (now deceased), Albrecht Claessens and Dan Daly (Katholieke Universiteit te Leuven, Belgium), Renaat Philippaerts (Ghent University, Ghent, Belgium), Lodovico Benso, Giulio Gilli, Lamberto Pastorin and Andrea Benso (University of Turin, Italy), Emma Laing and Rick Lewis (University of Georgia, Athens, GA, USA). Their kindness and willingness to share are greatly appreciated.

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Authors and Affiliations

  1. Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA

    Robert M. Malina (Research Professor, Visiting Professor)

  2. Department of Kinesiology, Tarleton State University, Stephenville, TX, USA

    Robert M. Malina (Research Professor, Visiting Professor)

  3. University School of Physical Education, Wrocław, Poland

    Robert M. Malina (Research Professor, Visiting Professor)

  4. Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

    Robert M. Malina (Research Professor, Visiting Professor)

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  1. Robert M. Malina
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Correspondence to Robert M. Malina.

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Malina, R.M. Skeletal Age and Age Verification in Youth Sport. Sports Med 41, 925–947 (2011). https://doi.org/10.2165/11590300-000000000-00000

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