Ultrasound-based bone age assessment in children and adolescents: a mini-review

Bone age assessment is a critical tool for evaluating skeletal maturity in children and adolescents, with implications for growth monitoring and clinical decision-making. While traditional radiographic methods such as the Greulich-Pyle and Tanner-Whitehouse systems remain the gold standard, concerns...

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Main Authors: Yixuan Zhang, Xiao Yang, Li Zhang, Zeqing Zhao, Yamei Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1615923/full
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author Yixuan Zhang
Xiao Yang
Li Zhang
Zeqing Zhao
Yamei Yang
author_facet Yixuan Zhang
Xiao Yang
Li Zhang
Zeqing Zhao
Yamei Yang
author_sort Yixuan Zhang
collection DOAJ
description Bone age assessment is a critical tool for evaluating skeletal maturity in children and adolescents, with implications for growth monitoring and clinical decision-making. While traditional radiographic methods such as the Greulich-Pyle and Tanner-Whitehouse systems remain the gold standard, concerns over ionizing radiation exposure have spurred interest in ultrasound-based alternatives. This mini-review synthesizes current evidence on ultrasound bone age assessment, highlighting its advantages as a radiation-free, non-invasive modality with strong correlations to radiographic standards. Key advancements include standardized scoring systems, ossification ratios (e.g., radius/ulna/femur), and acoustic measures (e.g., speed of sound), which enhance reliability and reduce inter-operator variability. However, challenges persist, including protocol standardization, population-specific variability, and operator dependency, particularly in advanced pubertal stages. Future directions emphasize the development of large-scale, longitudinal and multi-ethnic reference databases, consensus guidelines, and AI integration to improve precision. Ultrasound bone age assessment shows promise as a viable clinical tool, but further refinements are needed to address its limitations and ensure equitable applicability across diverse populations.
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series Frontiers in Pediatrics
spelling doaj-art-1a7e2c69042b4a39b401f7ddbebfd4ce2025-08-21T05:27:10ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16159231615923Ultrasound-based bone age assessment in children and adolescents: a mini-reviewYixuan ZhangXiao YangLi ZhangZeqing ZhaoYamei YangBone age assessment is a critical tool for evaluating skeletal maturity in children and adolescents, with implications for growth monitoring and clinical decision-making. While traditional radiographic methods such as the Greulich-Pyle and Tanner-Whitehouse systems remain the gold standard, concerns over ionizing radiation exposure have spurred interest in ultrasound-based alternatives. This mini-review synthesizes current evidence on ultrasound bone age assessment, highlighting its advantages as a radiation-free, non-invasive modality with strong correlations to radiographic standards. Key advancements include standardized scoring systems, ossification ratios (e.g., radius/ulna/femur), and acoustic measures (e.g., speed of sound), which enhance reliability and reduce inter-operator variability. However, challenges persist, including protocol standardization, population-specific variability, and operator dependency, particularly in advanced pubertal stages. Future directions emphasize the development of large-scale, longitudinal and multi-ethnic reference databases, consensus guidelines, and AI integration to improve precision. Ultrasound bone age assessment shows promise as a viable clinical tool, but further refinements are needed to address its limitations and ensure equitable applicability across diverse populations.https://www.frontiersin.org/articles/10.3389/fped.2025.1615923/fullbone age assessmentultrasound imagingskeletal maturitychildren and adolescentspediatric growth evaluation
spellingShingle Yixuan Zhang
Xiao Yang
Li Zhang
Zeqing Zhao
Yamei Yang
Ultrasound-based bone age assessment in children and adolescents: a mini-review
Frontiers in Pediatrics
bone age assessment
ultrasound imaging
skeletal maturity
children and adolescents
pediatric growth evaluation
title Ultrasound-based bone age assessment in children and adolescents: a mini-review
title_full Ultrasound-based bone age assessment in children and adolescents: a mini-review
title_fullStr Ultrasound-based bone age assessment in children and adolescents: a mini-review
title_full_unstemmed Ultrasound-based bone age assessment in children and adolescents: a mini-review
title_short Ultrasound-based bone age assessment in children and adolescents: a mini-review
title_sort ultrasound based bone age assessment in children and adolescents a mini review
topic bone age assessment
ultrasound imaging
skeletal maturity
children and adolescents
pediatric growth evaluation
url https://www.frontiersin.org/articles/10.3389/fped.2025.1615923/full
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AT zeqingzhao ultrasoundbasedboneageassessmentinchildrenandadolescentsaminireview
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