Bone age assessment, a crucial part of the diagnosis and management of pediatric growth disorders as well as the timing of certain pediatric orthopedic procedures, has for decades depended on the meticulous examination of plain radiographs. Examining the subtle changes present within the maturing human hand often proves to be challenging and time-consuming. Building on the popular Greulich and Pyle atlas, this book modernizes the method for pediatric skeletal maturity determination. It offers a wealth of images, carefully mined from thousands of digital radiographs from University of Virginia's Picture Archiving and Communication System (PACS), edited to best demonstrate important developmental bone features, and organized by age and sex for rapid reference. To expedite learning and clinical image analysis, images come in pairs: annotated and unannotated, for easy comparison. Succinct annotations on the images replace lengthy text to provide a quicker and clearer understanding of the skeletal age. These annotations highlight important and subtle features to help distinguish images that otherwise look superficially alike. The result is an atlas of exceptionally high quality skeletal radiographic standards that capture both the major and finer details of the accepted standards of Greulich and Pyle. The user-friendly format of this book enables a faster, more accurate, and more educational approach to determining skeletal maturity. The Digital Bone Age Companion packaged with the book is a computer program that facilitates viewing of the atlas images in digital format. Users can easily zoom in on radiographic features, set image level and width to their preference, and compare two or three reference standards side-by-side for difficult cases. Most importantly, the program expedites evaluation, optimizes workflow, and minimizes user-introduced errors with the reliable bone age calculator and built-in report generator. The digital format may also be available for integration with your Radiology Information System (RIS) for further workflow enhancement. Given the broad application of pediatric bone aging, Skeletal Development of the Hand and Wrist is not only intended for practicing and training radiologists, but for all of those who employ bone age studies as part of their practice.

In the past, determination of bone maturity relied on visual evaluation of skeletal development in the hand and wrist, most commonly using the Greulich and Pyle atlas. The Gilsanz and Ratib digital atlas takes advantage of digital imaging and provides a more effective and objective approach to assessment of skeletal maturity. The atlas integrates the key morphological features of ossification in the bones of the hand and wrist and provides idealized, sex- and age-specific images of skeletal development New to this revised second edition is a description and user manual for Bone Age for iPad®, iPhone® and iPod touch®, which can be purchased and used separately from this book. The App can be easily employed to calculate the deviation of the patient’s age from the normal range and to predict a possible growth delay. This easy-to-use atlas and the related App will be invaluable for radiologists, endocrinologists, and pediatricians and also relevant to forensic physicians.

The value of this atlas is to provide appropriate standards for the maturing skeleton {that} will enhance accuracy and ease interpretation -- From the Foreword by Theodore E. Keats, MD, Former Alumni Professor of Radiology, University of Virginia Health Sciences Center When dealing with the maturing skeleton and its many complex growth alterations, physicians are constantly faced with the question: Is this image normal? The Radiographic Atlas of Skeletal Maturation succinctly answers that question by providing a comprehensive set of male and female reference images for every age and body part. This allows physicians to quickly hone in on normal ranges for the specific case they are reviewing--particularly useful when called upon to read a pediatric skeletal radiograph in the emergency room or while on call. Special Features Access to nearly 2,300 high-quality images that provide instant reference to normal views of the skeleton at every developmental milestone-available in both the text and accompanying DVD Multiple projections at every age, sex, and body part combination so that the user can match the reference points in the book to the case at hand and arrive at a solid clinical interpretation (e.g., is the small fragment of bone observed in a 7-year-old boy with an acute elbow injury a fracture or a normal developing ossification center?) Practical text layout organized by gender and body part that provides quick access to images of normal development at any given age A software virtual skeletal survey demonstrates images of younger and older individuals and crystallizes the subtle variations in growth patterns Powerful software package with advanced image enhancement tools allows optimization of atlas image details for greater clarity. Compatible with numerous image formats (including DICOM) allowing viewing and editing of outside images Convenient growth charts included in the book and DVD for This unique resource, with its vast collection of print and DVD images of normal progressive skeletal development, gives physicians the full range of comparative information they need to interpret pediatric skeletal radiographs in any clinical setting. It is the reference standard for radiologists, pediatricians, orthopedists, emergency room physicians, internists, rehabilitation physicians, and training physicians who are called upon to review a pediatric radiograph and confidently make a diagnosis.

The first complete textbook and atlas of the vitally important technique of bone age assessment utilizing MRI for children's hand and wrist This latest volume in the growing Wiley Current Clinical Imaging series is a must-have resource that collects, in a single volume, all that is currently known and applicable about the use of magnetic resonance imaging (MRI) for the assessment of bone age. Presented in two parts, Text-Atlas of Skeletal Age Determination: MRI of the Hand and Wrist in Children first focuses on the anatomic, social, and legal aspects of bone age, providing a concise overview of the use of bone age determination in medical, legal, and social systems.??It then covers the clinical use and application of MRI in assessing bone age. The book offers complete chapter coverage on endocrinology, puberty, and disorders of pubertal development; bone marrow maturation in healthy and diseased states; growth failure and pediatric inflammatory bowel disease; skeletal findings in neurometabolic disease, genetic disease, and pediatric oncology patients; and much more. Text-Atlas of Skeletal Age Determination provides: A comprehensive review of the medical, legal, and social aspects of bone age assessment An in-depth discussion of MRI as an alternative to the traditional ionizing radiation-based radiographic techniques for the assessment of bone age Complete guidelines for clinical application of these MRI-based techniques "Recipes" for replicating these techniques and applications for diverse patient populations Cutting-edge information prepared and presented by an international team of experts A superb collection of beautifully reproduced, high-quality images This is an ideal book for radiologists, pediatricians, family physicians, endocrinologists, and sports medicine physicians interested in skeletal development and bone age assessment.

This Atlas is principally based on the Brush Foundation Study of Human Growth and Development, conceived in 1929 by Professor T. Wingate Todd of Western Reserve University School of Medicine. This intensive study collected data on the maturation of human anatomy through the meticulous X-raying of a series of research subjects enrolled in the study as juveniles—some as young as three months—and thereafter routinely weighed and measured at three-month to one-year intervals, depending on their age. This Atlas utilizes not only the X-ray films to which Todd had access but, also, those which were obtained in the six years subsequent to Todd's publication of his Atlas of Skeletal Maturation of the Hand. The X-ray standards in the present volume are, therefore, the first to be based exclusively on the research of the Brush Foundation Study.