The contribution of the carpal bones to the assessment of skeletal age

The hand‐wrist radiographs of 64 boys and 63 girls were examined to determine the effect of the elimination of the carpal centers from those considered in estimating the skeletal age using the 1959 standards of Greulich and Pyle. The carpals were found to be a source of significant variable error in girls in repeated readings by individual observers. In addition, they lagged behind epiphyseal centers, relative to the standards. Based on these and other considerations it is recommended that they not be considered in assessing skeletal age. The presence of systematic errors within and between experienced observers casts doubt upon the accuracy of the Inspectional Technique itself in cases where precise assessments are needed.