{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:50:13Z","timestamp":1791481813746,"version":"4.3.4"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2026-0164_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The Tanner-Whitehouse 3 (TW3) method recognized globally for assessing skeletal maturity are based primarily on Western and East Asian populations, limiting their accuracy when applied to Indian children. The objective of present study was to develop population-specific reference values for Skeletal Maturity Scores (SMS) in Indian children aged 1\u201318\u00a0years using the TW radius-ulna-short bones (RUS-13) system, and to validate these data against the in vogue TW3 system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0164_abs_003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analysed 3,549\u00a0left-hand radiographs (1,741 boys; 1,808 girls) from healthy Indian children obtained from previously approved bone age studies conducted between 2021 and 2024. Radiographs were scored using the TW3\u00a0RUS-13 method by two trained observers. Age- and sex-specific median SMS values were computed and smoothed using Gaussian curve fitting. The Indian SMS was validated prospectively in 50 children (20 healthy, 30 with endocrine disorders) and retrospectively for adult height prediction by substituting Indian bone ages into TW3 adult height prediction equations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0164_abs_004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SMS values increased progressively with age, showing earlier skeletal maturation in girls than boys. Indian children reached full skeletal maturity (SMS=1,000) at \u223c16.5\u00a0years in girls and \u223c17.5\u00a0years in boys. Comparison with TW2 and TW3 references indicated that Indian maturation patterns lie between these datasets. Validation demonstrated strong agreement between Indian and TW3 bone ages (ICC&gt;0.95) and improved accuracy in adult height prediction using Indian SMS (mean absolute error =\u00a0\u22120.1\u202fcm for Indian vs.\u00a0\u22120.9\u202fcm for\u00a0TW3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0164_abs_005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides the first comprehensive Indian reference for skeletal maturity assessment. The Indian SMS enhances clinical accuracy for growth evaluation, endocrine diagnosis, and height prediction, supporting region-specific references for pediatric skeletal maturity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2026-0164","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T02:56:04Z","timestamp":1784688964000},"page":"891-901","source":"Crossref","is-referenced-by-count":0,"title":["Development of radiographic references for skeletal maturity in Indian children"],"prefix":"10.1515","volume":"39","author":[{"given":"Vaman","family":"Khadilkar","sequence":"first","affiliation":[{"name":"Hirabai Cowasji Jehangir Medical Research Institute , Pune , Maharashtra , India"},{"name":"Senior Pediatric Endocrinologist, Jehangir Hospital , Pune , Maharashtra , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3399-3235","authenticated-orcid":false,"given":"Anuradha","family":"Khadilkar","sequence":"additional","affiliation":[{"name":"Hirabai Cowasji Jehangir Medical Research Institute , Pune , Maharashtra , India"},{"name":"Department of Health Sciences , Savitribai Phule Pune University , Pune , Maharashtra , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirantap","family":"Oza","sequence":"additional","affiliation":[{"name":"Hirabai Cowasji Jehangir Medical Research Institute , Pune , Maharashtra , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Mondkar","sequence":"additional","affiliation":[{"name":"Hirabai Cowasji Jehangir Medical Research Institute , Pune , Maharashtra , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Shah","sequence":"additional","affiliation":[{"name":"Hirabai Cowasji Jehangir Medical Research Institute , Pune , Maharashtra , India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"2026100816572549577_j_jpem-2026-0164_ref_001","unstructured":"Tanner, JM, Whitehouse, RH, Cameron, N, Marshall, WA, Healy, MJR, Goldstein, H. Assessment of skeletal maturity and prediction of adult height (TW2 method). London: Academic Press; 1975."},{"key":"2026100816572549577_j_jpem-2026-0164_ref_002","unstructured":"Tanner, JM, Healy, MJR, Goldstein, H, Cameron, N. Assessment of skeletal maturity and prediction of adult height (TW3 method), 3rd ed. London: Saunders; 2001."},{"key":"2026100816572549577_j_jpem-2026-0164_ref_003","unstructured":"Tanner, JM, Whitehouse, RH, Cameron, N, Marshall, WA, Healy, MJR, Goldstein, H. Assessment of skeletal maturity and prediction of adult height (TW2 method), 2nd ed. London: Academic Press; 1983."},{"key":"2026100816572549577_j_jpem-2026-0164_ref_004","unstructured":"Roche, AF, Wainer, H, Thissen, D. The RUS skeletal maturity method. Springfield: Charles C. Thomas; 1975."},{"key":"2026100816572549577_j_jpem-2026-0164_ref_005","doi-asserted-by":"crossref","unstructured":"Greulich, WW, Pyle, SI. Radiographic atlas of skeletal development of the hand and wrist, 2nd ed. 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