Choice of area for assessment

Multiple areas for assessment of skeletal maturity of an individual (hand, foot, knee, elbow, shoulder, hip) provide the broadest basis for accurate appraisal. Such studies are becoming progressively less feasible because: (1) the amount of radiation exposure involved may not be permitted; and (2) the greater time, expense and technical assistance required may not be justified by the knowledge yielded. For most statistical series it is desirable today to limit radiographs to one area. The left hand, including lower forearm, would seem the area of choice. It is most convenient, permits maximum subjects cooperation, is cheapest, most rapidly done, and may be repeated most often without objection. Uniformity and clarity of radiograms are also easiest to obtain. Standardization of techniques for use with both fixed and portable machines by widely separated workers is most readily attained. For special purposes the choice of area must be determined by the information sought. Special measures will often have to be devised to answer the questions being investigated.