Evaluation of Bone Age using Greulich-pyle method and Sauvegrain method in Girls with Precocious Puberty

초록

Objectives There are several methods of bone age(BA) assessment. Although evaluation of bone age using the Greulich-Pyle (GP) method has been the most widely used, it is difficult to assess BA in adolescents during puberty. Sauvegrain (SV) method is known to be useful alternative tool during puberty to determine BA from elbow radiograph. The aim of this study was to compare the differences of BA assessment by using GP method, SV method, olecranon maturation (OM) method in girls with central precocious puberty (CPP) Methods Between September 2014 and September 2016, A total of 63 CPP girls were included in this study. BA of all patients was evaluated periodically by GP, SV, and OM methods respectively. Two professional investigators evaluated BA of all patients according to each method of bone age measurement. The gap between GP and OM methods was classified into 6 months or less (Group 1) and 6 months or more (Group 2). Factors affecting to bone age maturation were analyzed in 2 groups with CPP girls. Results 1.While 60 patients (95.2%) ware able to be assessed bone age using SV methods, 28 patients (44.4%) were able to be assessed Bone age using OM method. 2.There was significant inter-variation between two invesigators about BA Assessment using only GP methods, not SV or OM methods. 3.There was no significant differences in the age, gender, body mass index standard deviation score, peak LH level, and estradiol values between two groups(group 1 and group 2) (P = 0.044). 4.The average changes of bone age during 6 months follow-up period were 3 months and 9.5 months in group 1, 2, respectively (p = 0.044) Conclusions It is difficult to assess BA through only GP method in CPP girls. Several method such as GP, SV or OM method are complementary each other. Further study is needed to evaluate the effectiveness of BA assessment using SV or OM method during puberty.