Bone Age in Adolescent Idiopathic Scoliosis
Research type
Research Study
Full title
A Comparison of Automated Tanner-Whitehouse 3 and Greulich Pyle Bone Age to other Radiological Assessments of Skeletal Maturity in Patients with Adolescent Idiopathic Scoliosis
IRAS ID
358063
Contact name
Ashley Cole
Contact email
Sponsor organisation
Sheffield Children's Hospital
Duration of Study in the UK
0 years, 5 months, 10 days
Research summary
Adolescent Idiopathic Scoliosis (AIS) is a curvature of the spine which occurs in teenagers and will often get worse with growth. Young people do not all grow at the same time related to their age with growth being better predicted from ‘bone age’ which can be assessed by looking at the growth plates (ends of the bones where the bones grow from). In scoliosis treatment, bone age is usually assessed from the growth plates in the hand and wrist and the growth plate on the top of the pelvis which can be seen on a spinal x-ray. With scoliosis worsening with growth, the bone age allows a prediction of times of rapid growth and remaining growth both of which are important in deciding best management of the scoliosis.
The growth plate on the top of the pelvis produces the Risser staging which is a visual assessment taking a few seconds. Calculating bone age from the hand and wrist has some simple methods which are visual producing categories (distal radius and ulna score, Sanders’ score) taking a few minutes. More complex but potentially more accurate measures taking 30-45 minutes produce Tanner Whitehouse 3 (TW3) and Greulich Pyle (GP) scores which are represented as actual bone ages rather than categories. Recently available Artificial Intelligence (AI) software allows an automated calculation of TW3 and GP bone ages in a few seconds. This has the potential to improve patient care but we need to understand how these measures of growth are related to each other. The final potential measure for assessing growth is serial measurement of standing height allowing calculation of growth velocity.
This project will evaluate actual (chronological) age, Risser staging, distal radius and ulna score, Sanders’ score, AI generated TW3 and GP scores from routine clinical radiographs and standing height in patients with AIS. This will allow us to evaluate which measure or combination of measures of skeletal maturity are best to use for decisions on brace starting, brace stopping and considering surgical treatment.REC name
London - Surrey Research Ethics Committee
REC reference
25/PR/0970
Date of REC Opinion
22 Jul 2025
REC opinion
Favourable Opinion