Interrelationship of the Risser sign, knee epiphysis, and bone age in determining skeletal maturity: A case-control study

Hak Jun Kim, Jung Ro Yoon, Chetna Modi, Hitesh Modi, Hae Ryong Song, Sang Youn Song

Research output: Contribution to journalArticle


The purpose of our study was to correlate the chronological age with Risser staging, knee epiphyseal closure, and bone age by the Tanner and Whitehouse (TW3) or Greulich and Pyle (GP) method simultaneously, to find out the most correlated methods used to calculate the age in a Korean population. A case-control study was carried out in 293 children between the age of 9 and 18 years. Skeletal age was estimated by using the atlas of the GP and TW3 methods; knee epiphysis closure and the Risser staging were also noted. Spearman's correlation coefficient test showed that in both the sexes the GP method is more correlated (r=0.58 for female patients, range: 0.55-0.61; and 0.58 for male patients, range: 0.54-0.61) with the Risser staging and physeal stages of the knee joint than the TW3 method (r=0.52 for female patients, range: 0.44-0.61; and 0.55 for male patients, range: 0.48-0.61) in Korean children. Our results suggested that by using the combination of Risser sign, knee epiphyseal closure, and GP bone age, one can calculate a person's chronological age most accurately.

Original languageEnglish
Pages (from-to)173-177
Number of pages5
JournalJournal of Pediatric Orthopaedics Part B
Issue number3
Publication statusPublished - 2011 May 1



  • Greulich and Pyle
  • knee physeal closure
  • Korean population
  • Risser sign
  • skeletal age
  • Tanner and Whitehouse

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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