The skeletal age of adolescents is essential for multiple purposes, including screening for growth disorders and treatment allocation. Chronologic age can be obtained from dental records or by chart review. Skeletal ages are routinely obtained by hand-wrist radiographs, but these are not widely used in pediatric practice due to the radiation burden. The use of magnetic resonance imaging (MRI) has been recommended in the evaluation of the adolescent wrist because of its ability to detect subluxations and changes in bone size and shape. However, a single coronal MRI sequence is recommended to be used in the diagnosis of skeletal age. To address this, a single coronal sequence was developed on the Philips 3 T MRI scanner and validated against hand radiographs and the Greulich-Pyle atlas in a large, consecutive series of adolescents. The age of 124 participants (69 girls, 55 boys; mean age 14.0 yr) was determined with both modalities (hand radiographs and MRI) and a total of 179 wrists were evaluated. Results show that the age of adolescents could be correctly estimated with less than 2 SD of chronological age using the MRI-based score in a routine scanner. The age of healthy adolescents could be correctly estimated by expert readers within 2 SD by hand MRI and the Greulich-Pyle atlas, with high agreement. However, when using only 1 SD, bone ages tend to be estimated as older than the chronologic ages. Future studies should evaluate the results in a larger number of participants.
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