The objectives of this study were: (1) to present methodological procedures used for the estimation of bone age; (2) describe the Tanner-Whitehouse method (TW3), and (3) to highlight the results of reproducibility of this method in children and adolescents. The method adopted for the preparation of the learning process and for evaluation of the reproducibility of the TW3 method was divided into three phases and was conducted at two teaching institutions (Portugal and Belgium) under the guidance and supervision of experienced raters. After several stages of training in the rating of radiographs, inter- and intraobserver reliability ranged from 81.3 to 87.9%. The final results of the study demonstrate the effectiveness of a rigorous training process as an essential element in the previous preparation of raters for the assessment of skeletal maturation by the TW3 method.
Growth; Development; Assessment; Radiography; Reproducibility
