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MINI REVIEW article

Front. Pediatr.

Sec. Pediatric Endocrinology

Volume 13 - 2025 | doi: 10.3389/fped.2025.1615923

Ultrasound-Based Bone Age Assessment in Children and Adolescents: A Mini-Review

Provisionally accepted
Yixuan  ZhangYixuan Zhang*Xiao  YangXiao Yang*Li  ZhangLi ZhangZeqing  ZhaoZeqing ZhaoYamei  YangYamei Yang
  • Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Dongcheng, China

The final, formatted version of the article will be published soon.

Bone age assessment is a critical tool for evaluating skeletal maturity in children and adolescents, with implications for growth monitoring and clinical decision-making. While traditional radiographic methods such as the Greulich-Pyle and Tanner-Whitehouse systems remain the gold standard, concerns over ionizing radiation exposure have spurred interest in ultrasound-based alternatives. This mini-review synthesizes current evidence on ultrasound bone age assessment, highlighting its advantages as a radiation-free, non-invasive modality with strong correlations to radiographic standards. Key advancements include standardized scoring systems, ossification ratios (e.g., radius/ulna/femur), and acoustic measures (e.g., speed of sound), which enhance reliability and reduce inter-operator variability. However, challenges persist, including protocol standardization, population-specific variability, and operator dependency, particularly in advanced pubertal stages. Future directions emphasize the development of large-scale, longitudinal and multi-ethnic reference databases, consensus guidelines, and AI integration to improve precision. Ultrasound bone age assessment shows promise as a viable clinical tool, but further refinements are needed to address its limitations and ensure equitable applicability across diverse populations.

Keywords: Bone age assessment, ultrasound imaging, Skeletal maturity, Children and adolescents, Pediatric growth evaluation

Received: 01 May 2025; Accepted: 31 Jul 2025.

Copyright: © 2025 Zhang, Yang, Zhang, Zhao and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Yixuan Zhang, Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Dongcheng, China
Xiao Yang, Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Dongcheng, China

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