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Greulich Pyle Hand Amp;Wrist Atlas.pdf PDF 9.00M

Greulich Pyle Hand amp;Wrist Atlas.pdf PDF 9.00M

The Greulich and Pyle Atlas is a classic radiological text that was first published in 1950 by William Walter Greulich and Sarah Idell Pyle. It is a reference book that contains a series of standard radiographs of the hand and wrist of children from different age groups, genders, and races. The atlas is used to assess the skeletal development and bone age of children by comparing their hand and wrist radiographs with the images in the atlas. The atlas is also useful for forensic purposes, such as estimating the age of unidentified remains or victims of child abuse.

The atlas was based on the data from the Brush Foundation Study of Human Growth and Development, which was established by Thomas Wingate Todd in 1929 at Western Reserve University School of Medicine. The study enrolled about 800 children from affluent families in Cleveland, Ohio, and performed serial x-rays of their hand and wrist at regular intervals from the age of three months to adulthood. Greulich, who succeeded Todd as the director of the study, and Pyle, who was a research associate, compiled and analyzed the data and produced the atlas.


The atlas consists of two parts: Part I contains 31 plates of hand and wrist radiographs for white males and females from birth to 19 years old, and Part II contains 11 plates for black males and females from birth to 18 years old. Each plate shows six images of different individuals with similar bone age. The bone age is determined by the appearance and fusion of the epiphyses (growth plates) of the bones in the hand and wrist. The atlas also provides tables that show the mean chronological age for each bone age group, as well as the standard deviation and range.

The Greulich and Pyle method is one of the two main ways to assess the bone age of children. The other method is the Tanner-Whitehouse method, which assesses and scores each bone separately before calculating an estimated age based on the assessed bones. The Greulich and Pyle method is simpler and faster, but it has some limitations. For example, it does not account for individual variations in growth patterns, it may not be applicable to children from different ethnic or geographic backgrounds, and it may be influenced by environmental factors such as nutrition or disease . Therefore, the bone age assessment should be interpreted with caution and in conjunction with other clinical information.

The Greulich and Pyle Atlas is still widely used in clinical practice and research, despite being more than 70 years old. It is available in various formats, such as printed books, digital files, or online applications. However, some researchers have suggested that there is a need for updating or revising the atlas to reflect the changes in growth patterns and population diversity over time .


  • Radiographic Atlas of Skeletal Development of the Hand and Wrist by WW Greulich and SI Pyle

  • Greulich and Pyle method

  • Radiographic atlas of skeletal development of the hand and wrist by William Walter Greulich

  • Greulich WW, Pyle SI. Radiographic Atlas of Skeletal Development of the Hand and Wrist. 2nd ed. Stanford: Stanford University Press; 1959.

  • Gilsanz V, Ratib O. Hand Bone Age: A Digital Atlas of Skeletal Maturity. Berlin: Springer; 2005.


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