Radiographic Atlas of Skeletal Development of the hand and wrist

1
Radiographic Atlas of Skeletal Development of the
hand and wrist

• Greulich and Pyle 2nd edition
• Prepared by Robert L Lorenzo, MD

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Male Newborn
3
Male 3 months
4
Male 6 months
5
Male 9 months
6
Male 1 year
7
Male 1 year and 3 months
8
Male 1 year and 6 months
9
Male 2 years
10
Male 2 years and 8 months
11
Male 3 years
12
Male 3 years and 6 months
Epiphyses of distal phalanges 2-5 clearly visible
13
Male 4 years
14
Male 4 years and 6 months
Middle phalangeal epiphyses of 3rd, 4th fingers
now slightly more than 1/2 as wide as their shafts
15
Male 5 years
Epiphysis of the first metacarpal is now more
than half as wide as its metaphysis The epiphysis
of the distal phalanx of the fifth finger is now
about 2/3s as wide as its shaft
16
Male 6 years
The base of the second metacarpal is now
distinctly indented in the region which will
later articulate with the trapezoid
17
Male 7 years
The epiphysis of the middle phalanx of the fifth
finger is now slightly more than half as wide as
its shaft.
18
Male 8 years
The epiphyses of the distal phalanges of the
second, third, fourth, and fifth fingers are now
as wide as their shafts.
19
Male 9 years
The distal ends of the shafts of the second and
third proximal phalanges have become slightly
concave as their trochlear surfaces begin to
differentiate.
20
Male 10 years
The epiphyses for the distal phalanges of the
second to fifth fingers are all wider than their
shafts.
21
Male 11 years
The epiphysis of the proximal phalanx of the
second finger is now as wide as its shaft.
22
Male 11 years and 6 months
The capitate surface of the scaphoid now slightly
overlaps the adjacent portion of the capitate.
23
Male 12 years and 6 months
The epiphysis of the proximal phalanges of the
3rd, 4th and 5th fingers and of the middle
phalanges of the 2nd and 3rd fingers are now as
wide as their shafts.
24
Male 13 years
The epiphysis of the middle phalanx of the fifth
finger is now as wide as its shaft.
25
Male 13 years and 6 months
All of the proximal epiphyses have begun to cap
their shafts.
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Male 14 years
27
Male 15 years
28
Male 15 years and 6 months
29
Male 16 years
30
Male 17 years
31
Male 18 years
32
Male 19 years
33
Female Newborn
34
Female 3 months
35
Female 6 months
36
Female 9 months
37
Female 1 year
The epiphyses of the second and third metacarpals
and the epiphyses of the proximal phalanges of
the second, third, and fourth fingers now contain
small, recently formed ossification centers
38
Female 1 year and 3 months
39
Female 1 year and 6 months
40
Female 2 years
41
Female 2 years and 6 months
42
Female 3 years
The epiphyses of the middle phalanges of the
second, third, and fourth fingers are now
slightly more than half as wide as their shafts.
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Female 3 years and 6 months
44
Female 4 years and 2 months
45
Female 5 years
The distal phalangeal epiphyses of the third,
fourth, and fifth fingers are now as wide as
their shafts
46
Female 5 years and 9 months
47
Female 6 years and 10 months
The base of the second metacarpal adjacent to the
trapezoid is now slightly concave.
48
Female 7 years and 10 months
The epiphysis of the proximal phalanx of the
thumb now extends farther medially (I.e., toward
the volar surface) than does the corresponding
border of its shaft it has now reached the
dorsal marginthe epiphyses of the distal
phalanges of the 2nd-5th fingers are shaping to
the trochlear surfaces of the middle phalanges.
49
Female 8 years and 10 months
The epiphyses of the proximal and middle
phalanges of the second, third, and fourth
fingers are now as wide as their shafts.
50
Female 10 years
The epiphyses of the proximal and middle
phalanges of the fifth finger are now as wide as
their shafts.
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Female 11 years
The epiphyses of the proximal and middle
phalanges of the 2nd-5th fingers and those of the
distal phalanges of the thumb and 2nd, 4th and
5th fingers now cap their shafts.
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Female 12 years
The radial epiphysis caps its shaft and its ulnar
articular surface has flattened.
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Female 13 years
The epiphysis of the distal phalanx of the thumb
has begun to fuse with its shaft.
54
Female 13 years and 6 months
55
Female 14 years
56
Female 15 years
57
Female 16 years
58
Female 17 years
59
Female 18 years
60
Female 28 years
61
Female 50 years
62
Standard Deviation for Boys
63
Standard Deviation for Girls
64
Table IIA Average Boys
65
Table IIB Average Boys
66
Table IIC Accelerated Boys
67
Table IID Accelerated Boys
68
Table IIE Retarded Boys
69
Table IIIA Average Girls
70
Table IIIB Average Girls
71
Table IIIC Accelerated Girls
72
Table IIID Accelerated Girls
73
Table IIIE Retarded Girls
74
Table IIIF Retarded Girls
75
Table I Percent of mature height