Parent-Child Similarities in Hand-Wrist Ossification

Ever since the advent of radiology, ossification of the hand and wrist has been used as a measure of maturational status. This was true for the original Wilms atlas of skeletal maturation published in 1902,¹and it has remained true for the more recent atlases of Flory,²Todd,³and both editions of Greulich and Pyle.⁴,⁵ Over the years, however, a few workers have called attention to familial patterns of ossification that complicate the interpretation of hand-wrist radiographs. Pryor, in particular, observed similarities in the ossification sequence of siblings.⁶,⁷Several reports from the Fels Research Institute have stressed family-line similarities in both ossification timing and ossification patterning.⁸⁻¹⁰We have previously described a familial syndrome involving the disproportionately late appearance of a cluster of carpal centers¹¹⁻¹²and have demonstrated twin similarities in both the sequences of hand ossification and epiphyseal union.¹³⁻¹⁴Recently, we have been able to extend our observations