Bone Age (Greulich & Pyle)
Manual atlas-matching tool for skeletal age estimation from a left-hand-and-wrist radiograph. The radiologist compares the film to the GP reference standards on their own workstation. Images are not stored; optional AI testing is local/prototype only. Decision-support only — always verify clinically.
Compare your film with the Greulich & Pyle reference standards on your own workstation or atlas. No images are uploaded here. The GP atlas is copyrighted (Stanford University Press, 1959).
View reference atlas ↗Method, references & caveats
Greulich & Pyle method: The left-hand-and-wrist radiograph is compared with the sex-specific photographic reference standards in the GP atlas (1959). The bone age is assigned as the closest matching standard.
Normal-range convention: Bone age is considered within the normal range if it falls within 2 SD of the patient's chronological age, where the SD is taken from the Brush Foundation normative data tabulated in the GP atlas (Table 2). See Berst et al. (AJR 2001) for reliability data.
Age rounding: Chronological age is computed to complete months; if the remaining days exceed 15, the age is rounded up by one month (standard paediatric radiology convention).
Caveats: GP norms are derived from a mid-20th-century North American cohort of predominantly high socioeconomic status and may systematically over- or under-estimate skeletal maturity in other ethnic or socioeconomic populations. Inter-observer variability of approximately 6–12 months is expected. Assessment is not validated for conditions selectively affecting individual bones. Correlate clinically.
Citations:
1. Greulich WW, Pyle SI. Radiographic Atlas of Skeletal Development of the Hand and Wrist. 2nd ed. Stanford University Press; 1959.
2. Berst MJ, Dolan L, Logeman MD, et al. Effect of knowledge of chronological age on the variability of pediatric bone age determined using the Greulich and Pyle standards. AJR Am J Roentgenol. 2001;176(2):507–510.
Select patient sex, enter dates, then choose the final reviewed bone age to see the result.
Save the reviewed bone age metadata and report only. Images, filenames, DOB, DICOM data, and uploads are not stored.
To enable: select patient sex, enter valid dates, select final reviewed bone age, generate report comment.