Authors
1 Department of Radiology, Isfahan University of Medicine Sciences, Isfahan, Iran
2 Department of Sport Medicine, Isfahan University of Medicine Sciences, Isfahan, Iran
Abstract
Background: Increasing of age cheating in sports makes problems to athletes comparable to taking illegal substances. Current method used by AFC and FIFA is applying MRI of growth plate of distal of radius to determine the bone age. This study was designed to evaluate the diagnostic accuracy of ultrasonography in bone age determination by measuring the width of growth plate in distal of radius, and comparing it with identity documents.
Materials and Methods: The study was conducted from September to December 2009 in the Department of Radiology at Al-Zahra University Hospital, Isfahan, Iran. Ultrasonography was done for 82 (15-20 years old) young professional football players and results were compared with identity documents (such as National ID card). Young football players were divided into three age categories: < 16 and > 16 years old, < 17 and > 17 years old, and < 18 and > 18 years old. Receiver Operator Characteristics (ROC) curves for discriminant values and sensitivity and specificity were analyzed.
Results: Cut-off point was set for each group, based on the width of the growth plate, and negative test was defined as subjects < cut-off point, showing subjects over the defined age in each group. ROC curve analysis demonstrates consistently acceptable diagnostic sensitivity and specificity values in age determination of each group.
Conclusions: The overall predictive accuracy of ultrasonography, as described by the area under the ROC curve, was high for determination of bone age. It has an acceptable sensitivity and specificity to use for determination of age in sport competitions, and has the capability to become the screening test for age determination, especially because it is inexpensive and without any risk of radiation. It seems to be comparable with MRI in age determination.
Keywords
1. | Kwenaite T. Little cheats: Who to blame? The Star Newspaper; Gauteng, South Africa: 26 Aug 1998. |
2. | Mokone T. Poverty no excuse for cheating. Available from: http://www.news24.com/Columnists/Archive/TumoMokone/Poverty-no-excuse-for-cheating-20040727[Last accessed on 2013 Mar 18]. |
3. | Kwenaite T. South Africa national under-14. The Star Newspaper; Gauteng, South Africa: 29 Aug 1998. |
4. | Kwenaite T. Safe to probe Amajita age cheats claims. Available from: http://www.iol.co.za/sport/safa-to-probe-amajita-age-cheats-claims-1.491111 [Last accessed on 2013 Mar 18]. |
5. | Kwenaite T. SA's world champs' cheated' in France. The Star Newspaper; Gauteng, South Africa: 22 Aug 1998. |
6. | Beunen GP, Malina RM, Lefevre J, Claessens AL, Renson R, Kanden Eynde B, et al. Skeletal maturation, somatic growth and physical fitness in girls 6-16 years of age. Int J Sports Med 1997;18:413-9. |
7. | King DG, Steventon DM, O'Sullivan MP, Cook AM, Hornsby VP, Jefferson IG, et al. Reproducibility of bone ages when performed by radiology registrars: An audit of Tanner and Whitehouse II versus Greulich and Pyle methods. Br J Radiol 1994;67:848-51. |
8. | Tanner JM, Whitehouse RH, Cameron N, Marshall WA, Healy MJ, Goldstein H. Assessment of skeletal maturity and prediction of adult height (TW2 Method). 2 nd ed. London: Academic Press; 1983. |
9. | Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2 nd ed. Stanford: Stanford University Press; 1959. |
10. | Castriota-Scanderbeg A, De Micheli V. Ultrasound of femoral head cartilage: A new method of assessing bone age. Skeletal Radiol 1995;24:197-200. |
11. | Wagner UA, Diedrich V, Schmitt O. Determination of skeletal maturity by ultrasound: A preliminary report. Skeletal Radiol 1995;24:417-20. |
12. | Bilgili Y, Hizel S, Kara SA, Sanli C, Erdal HH, Altinok D. Accuracy of skeletal age assessment in children from birth to 6 years of age with the ultrasonographic version of the Greulich-Pyle atlas. J Ultrasound Med 2003;22:683-90. |
13. | Shimura N, Satomi K, Osamu A, Imataka M, Sato K, Matsuura M. Assessment of measurement of children's bone age ultrasonically with Sunlight BonAge. Clin Pediatr Endocrinol 2005;14:17-20. |
14. | Dvorak J, George J, Junge A, Hodler J. Application of MRI of the wrist for age determination in international U-17 soccer competitions. Br J Sports Med 2007;41:497-500. |
15. | Dvorak J, George J, Junge A, Hodler J. Age determination by magnetic resonance imaging of the wrist in adolescent male football players. Br J Sports Med 2007;41:45-52. |
16. | Zadik Z, Bistrizer T, Tsoref L, Schwartz T, Yaniv I. A Novel Method for Assessing Bone Age Using Ultrasound. Available from: http://www.sunlightnet.com/international/html/BAZadik2003.pdf [Last accessed on 2013 Mar 18]. |
17. | Khan KM, Miller BS, Hoggard E, Somani A, Sarafoglou K. Application of ultrasound for bone age estimation in clinical practice. J Pediatr 2009;154:243-7. |
18. | Wagner UA, Diedrich V, Schmitt O. Determination of skeletal maturity by ultrasound: A preliminary report. Skeletal Radiol 1995;24:417-20. |
19. | Mentzel HJ, Vilser C, Eulenstein M, Schwartz T, Vogt S, Böttcher J, et al. Assessment of skeletal age at the wrist in children with a new ultrasound device. Pediatr Radiol 2005;35:429-33. |