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Bilateral Symmetry of Skeletal Maturation in the Human Hand and Wrist

Bilateral Symmetry of Skeletal Maturation in the Human Hand and Wrist Abstract In assessing skeletal age it is customary to examine roentgenograms of only one hand and wrist on the assumption that pronounced differences between the two sides are comparatively rare. Although homologous parts of the two sides of the skeleton may show considerable differences in development, the bulk of available evidence supports the thesis that, for all practical purposes, discrepancies between the two sides are too insignificant to constitute a source of error in the determination of skeletal status.1-8 This inference is derived from investigations of the number and size of ossification centers in the hand and wrist, chronological order of appearance of the carpal bones and secondary epiphyses, and detailed measurements of the carpal area. The delineation of skeletal maturation determiners of the hand and wrist, initiated by Rochlin9 and Todd10 and extended by Greulich and Pyle,11 permits a more precise estimation of the developmental status References 1. Long, E., and Caldwell, E. W.: Some Investigations Concerning the Relation Between Carpal Ossification and Physical and Mental Development . Am. J. Dis. Child. 1:113, 1911. 2. Stettner, E.: Über die Beziehungen der Ossifikation des Handskellets zu Alter und Längenwachstum bei gesunden und kranken Kindern von der Geburt bis zur Pubertät , Arch. Kinderh. 68: 342, 1921. 3. Baldwin, B. T.; Busby, L. M., and Garside, H. V.: Anatomic Growth of Children: A Study of Some Bones of the Hand, Wrist, and Lower Forearm by Means of Roentgenograms , (Studies in Child Welfare), Iowa City, Iowa, University of Iowa, 1928, Vol. 4, No. (1) . 4. Sawtell, R. O.: Ossification and Growth of Children from One to Eight Years of Age , Am. J. Dis. Child. 37:61, 1929. 5. Torgersen, J.: Asymmetry and Skeletal Maturation , Acta radiol . 36:521, 1951.Crossref 6. Flecker, H.: Roentgenographic Observations of the Times of Appearance of Epiphyses and Their Fusion with the Diaphyses , J. Anat. 67: 118, 1932. 7. Elgenmark, O.: The Normal Development of the Ossific Centres During Infancy and Childhood: Clinical, Roentgenologic, and Statistical Study , Acta pædiat. 33:1-79 ( (Suppl. 1) ), 1946.Crossref 8. Pryor, J. W.: Bilateral Symmetry as Seen in Ossification , Am. J. Anat. 58:87, 1936.Crossref 9. Rochlin, D. G.: Röntgenosteologie und Röntgenanthropologie, Mockba , Biomedgiz , 1936. 10. Todd, T. W.: Atlas of Skeletal Maturation (Hand) , St. Louis, C. V. Mosby Company, 1937. 11. Greulich, W. W., and Pyle, S. I.: Radiographic Atlas of Skeletal Development of the Hand and Wrist: Based on the Brush Foundation Study of Human Growth and Development Initiated by T. Wingate Todd, Stanford, Calif., Stanford University Press, 1950. 12. Pyle, S. I.; Mann, A. W.; Dreizen, S.; Kelley, H. J.; Macy, I. G., and Spies, T. D.: A Substitute for Skeletal Age (Todd) for Clinical Use: The Red Graph Method , J. Pediat. 32: 125, 1948.Crossref 13. Mainland, D.: Elementary Medical Statistics: The Principles of Quantitative Medicine , Philadelphia, W. B. Saunders Company, 1952. 14. Caffey, J.: Pediatric X-Ray Diagnosis: A Textbook for Students and Practitioners of Pediatrics , Surgery & Radiology, Ed. 2, Chicago, The Year Book Publishers, Inc., 1950. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1957.02060040124004
Publisher site
See Article on Publisher Site

Abstract

Abstract In assessing skeletal age it is customary to examine roentgenograms of only one hand and wrist on the assumption that pronounced differences between the two sides are comparatively rare. Although homologous parts of the two sides of the skeleton may show considerable differences in development, the bulk of available evidence supports the thesis that, for all practical purposes, discrepancies between the two sides are too insignificant to constitute a source of error in the determination of skeletal status.1-8 This inference is derived from investigations of the number and size of ossification centers in the hand and wrist, chronological order of appearance of the carpal bones and secondary epiphyses, and detailed measurements of the carpal area. The delineation of skeletal maturation determiners of the hand and wrist, initiated by Rochlin9 and Todd10 and extended by Greulich and Pyle,11 permits a more precise estimation of the developmental status References 1. Long, E., and Caldwell, E. W.: Some Investigations Concerning the Relation Between Carpal Ossification and Physical and Mental Development . Am. J. Dis. Child. 1:113, 1911. 2. Stettner, E.: Über die Beziehungen der Ossifikation des Handskellets zu Alter und Längenwachstum bei gesunden und kranken Kindern von der Geburt bis zur Pubertät , Arch. Kinderh. 68: 342, 1921. 3. Baldwin, B. T.; Busby, L. M., and Garside, H. V.: Anatomic Growth of Children: A Study of Some Bones of the Hand, Wrist, and Lower Forearm by Means of Roentgenograms , (Studies in Child Welfare), Iowa City, Iowa, University of Iowa, 1928, Vol. 4, No. (1) . 4. Sawtell, R. O.: Ossification and Growth of Children from One to Eight Years of Age , Am. J. Dis. Child. 37:61, 1929. 5. Torgersen, J.: Asymmetry and Skeletal Maturation , Acta radiol . 36:521, 1951.Crossref 6. Flecker, H.: Roentgenographic Observations of the Times of Appearance of Epiphyses and Their Fusion with the Diaphyses , J. Anat. 67: 118, 1932. 7. Elgenmark, O.: The Normal Development of the Ossific Centres During Infancy and Childhood: Clinical, Roentgenologic, and Statistical Study , Acta pædiat. 33:1-79 ( (Suppl. 1) ), 1946.Crossref 8. Pryor, J. W.: Bilateral Symmetry as Seen in Ossification , Am. J. Anat. 58:87, 1936.Crossref 9. Rochlin, D. G.: Röntgenosteologie und Röntgenanthropologie, Mockba , Biomedgiz , 1936. 10. Todd, T. W.: Atlas of Skeletal Maturation (Hand) , St. Louis, C. V. Mosby Company, 1937. 11. Greulich, W. W., and Pyle, S. I.: Radiographic Atlas of Skeletal Development of the Hand and Wrist: Based on the Brush Foundation Study of Human Growth and Development Initiated by T. Wingate Todd, Stanford, Calif., Stanford University Press, 1950. 12. Pyle, S. I.; Mann, A. W.; Dreizen, S.; Kelley, H. J.; Macy, I. G., and Spies, T. D.: A Substitute for Skeletal Age (Todd) for Clinical Use: The Red Graph Method , J. Pediat. 32: 125, 1948.Crossref 13. Mainland, D.: Elementary Medical Statistics: The Principles of Quantitative Medicine , Philadelphia, W. B. Saunders Company, 1952. 14. Caffey, J.: Pediatric X-Ray Diagnosis: A Textbook for Students and Practitioners of Pediatrics , Surgery & Radiology, Ed. 2, Chicago, The Year Book Publishers, Inc., 1950.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1957

References