Assessment of Bone Age in Pediatric Patient Using X-ray, Thyroid Stimulating Hormones (TSH), and Vitamin D

Authors

  • Oinam Gokulchandra Singh
  • Ali Aldhebaib
  • Hosam Shujaa Alharthi
  • Thittamaranahalli Muguregowda Honnegowda
  • Abdullah Mones Alamri
  • Aljawharah Nawaf Alotaibi
  • Jayachandran Vetrayan
  • Smily Jesu Priya Victor Paulraj
  • Mohammed Ziyad Alturki
  • Turki Ayed Alharthi
  • Fayaz ul Haq
  • Winni Philip

Keywords:

Vitamin D, Thyroid-stimulating hormone (TSH), Radiological age, Pediatric skeletal maturation, Greulich-pyle (GP) method, Bone age assessment (BA)

Abstract

Bone age (BA) assessment is crucial in evaluating skeletal development and diagnosing endocrine and growth disorders in pediatric patients. The Greulich-Pyle (GP) method remains widely used, though artificial intelligence (AI) advancements are enhancing accuracy. Vitamin D and thyroid-stimulating hormone (TSH) also play key roles in bone metabolism, yet their impact on BA remains unclear. This study investigates the bone age assessment using X-ray, Thyroid Stimulating Hormones (TSH), and Vitamin D among the pediatric patients visiting King Abdullah Specialist Children (KASCH), Riyadh, Saudi Arabia

Materials and Methods

A cross-sectional study was conducted at King Abdullah Specialized Children's Hospital (KASCH), Riyadh, Saudi Arabia, utilizing retrospective data from 100 pediatric patients aged between 1-16 years, covering the period from 2019 to 2020. BA was assessed using left-hand radiographs analyzed with the GP method. Vitamin D and TSH levels were measured using serum 25-hydroxy vitamin D [25(OH) D] and electrochemiluminescence immunoassay (ECLIA) test. Pearson and Spearman correlation analyses determined associations between BA, chronological age, vitamin D, and TSH levels.

Results

A strong positive correlation was observed between chronological age and BA (r = 0.858, p = 0.001), validating the reliability of the GP method. Vitamin D levels exhibited a weak negative correlation with age (r = -0.261, p = 0.031) and BA (r = -0.226, p = 0.064), while TSH showed no significant association with either (p > 0.05). Most patients (57.4%) had insufficient vitamin D levels, whereas 94% had normal TSH levels.

Conclusion

Chronological age and BA strongly correlate, confirming the GP method's applicability. However, vitamin D and TSH showed limited influence on skeletal maturation, highlighting the need for further research to determine their precise roles in bone development.

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Published

2025-05-08

How to Cite

1.
Gokulchandra Singh O, Aldhebaib A, Shujaa Alharthi H, Muguregowda Honnegowda T, Mones Alamri A, Nawaf Alotaibi A, et al. Assessment of Bone Age in Pediatric Patient Using X-ray, Thyroid Stimulating Hormones (TSH), and Vitamin D. J Neonatal Surg [Internet]. 2025 May 8 [cited 2026 Apr. 1];14(21S):603-10. Available from: https://jneonatalsurg.com/index.php/jns/article/view/5371

Issue

Vol. 14 No. 21S (2025): Journal of Neonatal Surgery

Section

Original Article

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