Comparative study between bone ages: Carpal, Metacarpophalangic, Carpometacarpophalangic Ebrí, Greulich and Pyle and Tanner Whitehouse2.

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Bernardo Ebrí Torné


We have carried out a review study in order to remind the pediatrician of the differences in bone age (EO) between the existing Greulich-Pyle (GP) or Tanner-Whitehouse 2 (TW2) methods compared to Ebrí ages: EO Ebrí-carpal (EOIC) metacarpophalangic (EOIMF) and Carpometacarpophalangic (EOICMF). The study was carried out in Spanish longitudinal casuistry “Andrea Prader”. It comprises 160 healthy children: 73 males and 87 females, distributed by sex and age from 0.5 to 20 years. By obtaining the EO for each method, a comprehensive study can be carried out between them, and thus, observing if there are differences, being able to offer a quantification  to the pediatrician for him to take them into account. In previous studies, the equations for obtaining the EO were expressed by the Ebrí methods. These quantifications are presented throughout this review.

In this way, the doctor will be able to know the equivalences to EO Ebrí, when he only has the EO of a child by the GP or TW2 methods. However, when the pediatrician obtains the EO with our method, no correction is necessary for a Spanish child since it has been obtained directly, and not through the filter of the two English and American methods. When the Ebrí method is applied to non-Spanish children, it is also convenient to assess these differences.

We observe how in women, GP has a tendency to overestimate, while Tanner and our methods tend to underestimate. In men, not only GP has a tendency to overestimate but also TW2 compared to our methods.

Quantifying these differences translated into months, it is observed how in TW2 women, even underestimating a month and a half with respect to GP, presents an overestimation of 3 months with respect to EOIMF, 4 months with respect to EOIC and 4.7 months with respect to EOICMF. GP presents differences of up to 6 months with respect to EOIC, 6.5 months with respect to EOICMF, and 5 months with respect to EOIMF.

In males, TW2 presents overestimations of EO of up to 4 months different from EOICMF, 5 months from EOIMF and EOIC, and about a month and a half from GP. Greulich and Pyle show minor overestimations, up to 3.3 months with respect to EOIMF, 3.7 months with respect to EOIC, and 2.7 months with respect to EOICMF.

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TORNÉ, Bernardo Ebrí. Comparative study between bone ages: Carpal, Metacarpophalangic, Carpometacarpophalangic Ebrí, Greulich and Pyle and Tanner Whitehouse2.. Medical Research Archives, [S.l.], v. 9, n. 12, dec. 2021. ISSN 2375-1924. Available at: <>. Date accessed: 08 aug. 2022. doi:
Review Articles


1. Ebrí Torné B et al., Studies in Spanish Children to Calculate Bone Age and Predict Adult Height: Forty Years of Own Investigation . Pediat Therapeut 2015, 5:1
2.í Torné B, Ebrí Verde I. Índices numéricos Ebrí metacarpofalángico y carpiano para el cálculo de la edad ósea y predicción de talla adulta. An Pediatr (Barc).2012; 76(4):199-213.
3. Ebrí Torné B. Ebrí method for the calculation of bone age and prediction of adult height (How to download the software). ESMED Congress European Society of Medicine. Viena11 - 13 Noviembre 2021.mp4 56.08MB
4. Greulich W, Pyle S J. Radiographic atlas of skeletal development of the hand wrist. 2º ed. California: Stanford University Press; 1959.
5. Tanner JM, Whitehouse R H, Healy M J R, Goldstein H. A revised system for estimating skeletal maturity from hand and wrist radiograps with separate standards for carpals and other bones (TW2 system). Standards for skeletal age. París: International Children´s Centre; 1972.
6. Ferrández Longás A. Estudio longitudinal de niños españoles normales desde nacimiento hasta la edad adulta. Datos antropométricos, puberales, radiológicos e intelectuales. Zaragoza: Fundación Andrea Prader; 2005.
7. Martí Henneberg C, Roy MP, Passe NP. The analysis of skeletal maturation in man (El análisis de la maduración esquelética en el hombre). Metodología, Med Clin 1975; 2: 49.
8. Ebrí Torne B. Maturation on Tarsus and carpal bone (Clinical-radiological study Child) Editorial Heraldo de Aragón. Zaragoza 1988.
9. Ebrí Torné B, Ebrí Verde I. Bone Maturation in Spanish Child by Locals and Foreing Methods of Assessment of Bone Age and Prediction of Adult Size [Maduración Ósea en el niño español por diferentes métodos propios y foráneos de Valoración de la Edad Ósea y de Predicción de Talla adulta] INO Editorial. Zaragoza, Spain Z-384.2015.
10. Peña E, Cardenas E, JL del Olmo. Bone growth and maturation athletes tweens and teens. Galvan and Ramos R (Eds). Antro is Biol. II Colloquium Antro. Physical J. Comas, México City: Antro Inv Inst 1982; 453-66.
11. Eiben OG, Panto E, Cyenis G, Frohlich J. Physique of young female gymnasts. Anthrop Kazl 1986; 30: 209-20.
12. Ebrí Torné B. Metacarpophalangeal bone titration index. Longitudinal study of a Swiss child. Study compared with Tanner II Rus [Indice de valoración Ósea Metacarpofalángico. Estudio Longitudinal de niño Suizo. Estudio comparado con Tanner II Rus. Act Pediatr Esp 1996; 54: 94-102.
13. Ebrí Torné B: Comparative study of Greulich & Pyle American Atlas of Swiss and Spanish population, through the Bone Age calculation methods of Greulich & Pyle, and Ebrí carpal. Annals of Miguel Servet Hospital 1992, 4:83-90.
14. Ebrí Torné B: IVO Carpal of Swiss Child (Lengthwise Study of Zurich). Acta Pediatr Esp1993, 51:651-654.
15. Ebrí Torné B: Metacarpal-phalanx bone valuation index. Swiss Lengthwise Study. Comparative study with Tanner II Rus. Acta Pediatr Esp 1996, 54:94-102.
16. Ebrí Torné B: Comparative study of bone ages Tanner-Rus, Tanner Carpal, Ebrí carpal, Ebrí Metacarpal-phalanx, and Greulich & Pyle. Acta Pediatr Esp 1997, 55:369-374.
17. Hernández M, Sánchez E, Sobradillo B, Rincón JM. Maduración ósea y pre- dicción de talla adulta. Atlas y métodos numéricos. Madrid: Ed. Díaz de Santos; 1991.
18. Tanner J, Oshman D, Bahhage F, Healy M. Tanner-Whitehouse bone age references values for North American children. J Pediatr.1997; 131(1): 34-40.
19. Tanner J, Whitehouse R, Cameron N, Marshall W, Healy M, Goldstein H. Assessment of skeletal maturity and pre- diction of adult height (TW3 method). 3ª ed. London W.B. Saunders; 2001.
20. Sarria A, Bueno-Lozano M, Moreno L, Bueno M. En: Bueno M, editor. Crecimiento y Desarrollo humano y sus trastornos. Madrid: Ergon; 1993. p. 57-68.
21. Ebrí Torné B. Contribución al estudio de la osificación del Tarso. Estudio de la edad ósea desde el nacimiento hasta los 16 años, siguiendo metodología numérica, basada en un índice obtenido en el tarso, denominado Indice Tarsiano”. Revista del Seminario de la Cátedra de Patología Médica A de Barcelona. Arch Med Esp Intern. 1977; 10: 721-24.
22. Ebrí Torné B. Ebrí Verde I. Bone Maturation and Height Prediction: Historical Review of the calculation methods. Jirmeps, 10 (1): 24-33, 2016.