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Protocol - Bone Age

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Protocol Name from Source:

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

Availability:

Publicly available

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:

[link[vl.academicdirect.org/medical_informatics/bone_age/v1.0/|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
Average time of greater than 15 minutes in an unaffected individualYes
Major equipmentYes
Specialized requirements for biospecimen collectionNo
Specialized trainingYes

Mode of Administration

Self-administered

Life Stage:

Toddler, Child, Adolescent

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.

Research Domain Information

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.

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 Value4798035CDE 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_RadiusPX220301010000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_UlnaPX220301020000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_First_MetacarpalPX220301030000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Third_MetacarpalPX220301040000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Fifth_MetacarpalPX220301050000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_ProximalPhalanxa_ThumbPX220301060000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_ProximalPhalanxa_Third_FingerPX220301070000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_ProximalPhalanxa_Fifth_FingerPX220301080000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Middle_Plananx_ThirdFingerPX220301090000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Middle_Plananx_FifthFingerPX220301100000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_DistalPhalanx_ThumbPX220301110000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Distal_Phalanx_ThirdFingerPX220301120000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Distal_Phalanx_FifthFingerPX220301130000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_CapitatePX220301140000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_HamatePX220301150000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_TriquetralPX220301160000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_LunatePX220301170000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_ScaphoidPX220301180000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_TrapeziumPX220301190000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_TrapexoidPX220301200000findings associated with each of the following 20 regions of interest (ROI) of the left hand as seen on x-ray4N/A
PX220301_Bone_Age_Patient_NamePX220301210000Patient Full Name4N/A
PX220301_Bone_Age_Patient_AddressPX220301220000Patient's Address4N/A
PX220301_Bone_Age_Xray_DatePX220301230000Date of X-Ray4N/A
PX220301_Bone_Age_DiagnosticPX220301240000Diagnoistic Code4N/A
PX220301_Bone_Age_Patient_GenderPX220301250000Patient gender4N/A
PX220301_Bone_Age_Patient_WeightPX220301260000Patient Weight4Variable Mapping
PX220301_Bone_Age_Patient_AgePX220301270000Patient Age in Years and Months4N/A
PX220301_Bone_Age_Patient_HeightPX220301280000Patient Height4N/A