A comparison between radiographic and sonographic assessment of hand and wrist bones for the estimation of skeletal age in the child patient

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ABSTRACT

Aim

The purpose of this study was to examine, with a sonographic investigation, the hand and wrist bones of a group of
young patients and to compare the results with those obtained with a classical radiographic assessment.

Methods

Some 25 subjects, 9 - 18 years of age, who presented problems concerning their short stature or precocious puberty, were evaluated.
Each subject was examined by a standard radiographic assessment and by a sonographic investigation with real-time imaging.
Sonographic examination was performed on the metacarpus-phalanx articulation of the first finger in order to locate the sesamoid bone.
Sonographic examination was also performed on the second and third phalanxes of the third finger and on the distal portion of the
radius to evaluate the characteristics of growth cartilage in the area. RESULTS AND STATISTICS: In all the cases where a sesamoid
bone was present, this was correctly identified by the sonogram, even up to the initial appearance of its ossification nucleus. Sensitivity,
specificity, and diagnostic accuracy were all 100. The capping phenomenon seen in radiographs was not detected by
sonographic investigation in any of the cases. Sonographic evaluation of the fertile cartilage of the third finger distal phalanx
demonstrated a sensitivity of 89, a specificity of 100 and a diagnostic accuracy of 92. Sonographic evaluation
of the radius cartilage showed a sensitivity of 95, a specificity of 100 and a diagnostic accuracy of 96.

Conclusion

Sonographic evaluation of hand and wrist bones cannot accurately reproduce the results of the classical radiographic
evaluation. However, the sonographic investigation may be useful, when integrated in a radiographic investigation.

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