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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.

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.

Availability

Available

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.

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

Lifestage

Toddler, Child, Adolescent

Participants

Ages 2-18 years old

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
Human Phenotype Ontology Delayed bone age HP:0002750 HPO
Human Phenotype Ontology Dysharmonic bone age HP:0200000 HPO
Human Phenotype Ontology Accelerated skeletal maturation HP:0005616 HPO
caDSR Form PhenX PX220301 - Bone Age 6201642 caDSR Form
Derived Variables

None

Process and Review

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

Protocol Name from Source

Tanner and Whitehouse Method (TW2)

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

Measure Protocols
Protocol ID Protocol Name
220301 Bone Age
Publications

There are no publications listed for this protocol.