RadteraXR Bone Age (Pediatric Left Hand and Wrist)
XRNo contrastPediatric
Indications
- Assessment of skeletal maturity vs chronologic age
- Short stature/growth disorders
- Precocious or delayed puberty
- Endocrine disorders
- Growth hormone therapy monitoring
Patient prep
- Remove rings/radiopaque objects from left hand and wrist
Contrast
None / non-contrast
Technique
- PA projection of the LEFT hand and wrist (left used by convention for standardization)
- Hand flat and pronated on IR, fingers slightly separated
- CR perpendicular to 3rd MCP joint
- SID 40 inches; kVp ~50-60; tabletop, low dose
- Include distal radius/ulna and all phalanges
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | PA left hand and wrist | Frontal | Single PA view of left hand including carpals, metacarpals, phalanges, and distal radius/ulna; compared to Greulich-Pyle atlas or scored by Tanner-Whitehouse |
Key points
- Left hand is the standard reference for Greulich and Pyle / Tanner-Whitehouse atlases
- Single PA view is sufficient; no lateral needed routinely
- Image quality must allow visualization of epiphyseal ossification centers and growth plates
- Low-dose pediatric technique
References
• Bontrager's Handbook - Pediatric Bone Age
• Merrill's Atlas Vol 3 - Pediatric Radiography
• Greulich & Pyle Radiographic Atlas of Skeletal Development of the Hand and Wrist
• Radiopaedia: Bone age link
• Merrill's Atlas Vol 3 - Pediatric Radiography
• Greulich & Pyle Radiographic Atlas of Skeletal Development of the Hand and Wrist
• Radiopaedia: Bone age link
Source: Researched — verify against your institution
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Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.