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Protocol - Bone Age

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Description:

The latest Tanner and Whitehouse Method, sometimes referred to as TW2, involves the interpretation of a radiograph of the left hand and wrist by a trained radiologist. The procedure includes the assessment of regions of interest (ROI) on 20 bones. The ROI include the epiphysis, metaphysis and diaphysis of each bone. The radiologist gives each ROI a numerical score and records the result. The numerical score of each ROI is summed to produce a total score.

Protocol:

The Tanner-Whitehouse Test is an online tool which was developed by Lorentz Jantschi and Sorana Bolboaca and is available at:

vl.academicdirect.org/medical_informatics/bone_age/v1.0/

The tool describes various findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray. The ROIs are the:

  • Radius
  • Ulna
  • First, third, and fifth metacarpal
  • Proximal phalanx of the thumb, third finger, and fifth finger
  • Middle phalanx of the third and fifth finger
  • Distal phalanx of the thumb, third finger, and fifth finger
  • Capitate
  • Hamate
  • Triquetral
  • Lunate
  • Scaphoid
  • Trapezium
  • Trapezoid

Users select a finding that matches what they see on the x-ray. Each finding has two x-ray images, a drawing and a written description. Once a selection is made for each ROI, the users enters the patient’s name*, address, x-ray date, diagnostic, gender, weight, height and age (in years and months, for example 11 years and 3 months). Then the program calculates the individual’s bone age based upon the standard atlas associated with the Tanner and Whitehouse method. *See Specific Instructions for suggestions regarding personal identifying information.

Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Personnel and Training Required

A radiologist professionally trained to evaluate bone age via the Tanner and Whitehouse Method.

Equipment Needs

X-ray machine

Requirements
Requirement CategoryRequired
Major equipment Yes
Specialized training Yes
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual Yes
Mode of Administration

Noninvasive radiologic assessment

Life Stage:

Toddler, Child, Adolescent

Participants:

Ages 2-18 years old

Specific Instructions:

This protocol must be administered by a radiologist professionally trained to evaluate bone age via the Tanner and Whitehouse Method. Since the online tool collects personal identifying information (PII), the researcher should use the individual’s initials and not include other identifiable information such as the person’s address.

Selection Rationale

The Rare Genetic Conditions Working Group selected the Tanner and Whitehouse Method because it is the most reproducible and, potentially, the most accurate procedure to determine bone age.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Bone Growth Calculated Bone age Value 4798035 CDE Browser
Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Online tool for assessment:

Jantschi, L., & Bolboaca, S. (2003). Tanner and Whitehouse Test. Available at vl.academicdirect.org/medical_informatics/bone_age/v1.0/

Original source:

Tanner, J. M., Whitehouse, R. H., Marshall, W. A., Healey, M. J. R., Goldstein, H. (1976). Assessment of skeletal maturity and prediction of adult height (TW2 method). London: Academic Press.

General References

Bull, R. K., Edwards, P. D., Kemp, P.M., Fry, S., & Hughes, I.A. (1999). Bone age assessment: A large scale comparison of the Greulich and Pyle, and Tanner and Whitehouse (TW2) methods. Archives of Disease in Childhood, 81, 172-173.

Ostojic, S. M. (2013). Prediction of adult height by Tanner-Whitehouse method in young Caucasian male athletes. QJM, 106, 341-345.

Protocol ID:

220301

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX220301_Bone_Age_Capitate PX220301140000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Diagnostic PX220301240000 Diagnoistic Code 4 N/A
PX220301_Bone_Age_DistalPhalanx_Thumb PX220301110000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Distal_Phalanx_FifthFinger PX220301130000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Distal_Phalanx_ThirdFinger PX220301120000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Fifth_Metacarpal PX220301050000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_First_Metacarpal PX220301030000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Hamate PX220301150000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Lunate PX220301170000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Middle_Plananx_FifthFinger PX220301100000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Middle_Plananx_ThirdFinger PX220301090000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Patient_Address PX220301220000 Patient's Address 4 N/A
PX220301_Bone_Age_Patient_Age PX220301270000 Patient Age in Years and Months 4 N/A
PX220301_Bone_Age_Patient_Gender PX220301250000 Patient gender 4 N/A
PX220301_Bone_Age_Patient_Height PX220301280000 Patient Height 4 N/A
PX220301_Bone_Age_Patient_Name PX220301210000 Patient Full Name 4 N/A
PX220301_Bone_Age_Patient_Weight PX220301260000 Patient Weight 4 Variable Mapping
PX220301_Bone_Age_ProximalPhalanxa_Fifth_Finger PX220301080000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_ProximalPhalanxa_Third_Finger PX220301070000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_ProximalPhalanxa_Thumb PX220301060000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Radius PX220301010000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Scaphoid PX220301180000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Third_Metacarpal PX220301040000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Trapexoid PX220301200000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Trapezium PX220301190000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Triquetral PX220301160000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Ulna PX220301020000 findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray 4 N/A
PX220301_Bone_Age_Xray_Date PX220301230000 Date of X-Ray 4 N/A
Research Domain Information
Measure Name:

Bone Age

Release Date:

April 30, 2015

Definition

A clinical assessment of the bone growth of the left hand via an x-ray.

Purpose

Bone age is an assessment of skeletal maturity and can be compared with chronological age to determine if there are abnormalities in development.

Keywords

Bone, age, bone age, x-ray, radiologist, Tanner and Whitehouse Method, TW2, growth, height, developmental delay, adolescent, short stature, endocrine disorders, bone age assessment, BAA, hormone therapy, skeletal maturity