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Abstract

Bone age (BA) assessment is crucial in evaluating skeletal development and diagnosing endocrine and growth disorders in pediatric patients. The Greulich-Pyle (GP) method remains widely used, though artificial intelligence (AI) advancements are enhancing accuracy. Vitamin D and thyroid-stimulating hormone (TSH) also play key roles in bone metabolism, yet their impact on BA remains unclear. This study investigates the bone age assessment using X-ray, Thyroid Stimulating Hormones (TSH), and Vitamin D among the pediatric patients visiting King Abdullah Specialist Children (KASCH), Riyadh, Saudi Arabia
Materials and Methods
A cross-sectional study was conducted at King Abdullah Specialized Children's Hospital (KASCH), Riyadh, Saudi Arabia, utilizing retrospective data from 100 pediatric patients aged between 1-16 years, covering the period from 2019 to 2020. BA was assessed using left-hand radiographs analyzed with the GP method. Vitamin D and TSH levels were measured using serum 25-hydroxy vitamin D [25(OH) D] and electrochemiluminescence immunoassay (ECLIA) test. Pearson and Spearman correlation analyses determined associations between BA, chronological age, vitamin D, and TSH levels.
Results
A strong positive correlation was observed between chronological age and BA (r = 0.858, p = 0.001), validating the reliability of the GP method. Vitamin D levels exhibited a weak negative correlation with age (r = -0.261, p = 0.031) and BA (r = -0.226, p = 0.064), while TSH showed no significant association with either (p > 0.05). Most patients (57.4%) had insufficient vitamin D levels, whereas 94% had normal TSH levels.
Conclusion
Chronological age and BA strongly correlate, confirming the GP method's applicability. However, vitamin D and TSH showed limited influence on skeletal maturation, highlighting the need for further research to determine their precise roles in bone development.