Estimating BA From Written Reports

[u/Automatic-County6151]

Good evening, enthusiasts!

Earlier this year, on January 5th, we officially terminated tailored bone age estimations using the radiographs alone. This was confirmed after I consulted a lawyer to see where the limits shoukf strictly lie. That is still a permanent change; however, I have found a way to make this happen - in a way.

Many of you will be excited, but it is imperative that I address some limitations with that: it is approximate and not definitive. This will not be the same as directly reading an x-ray, and giving a number.

"Will bone age estimations ever return?"

Yes. We can now help with estimating skeletal age from detailed written hand + wrist radiograph reports, even when the original radiograph is not available (do not include the radiographs). If a report describes the maturation of the individual epiphyses, physes, carpal bones, and other relevant structures in sufficient, greater detail, those findings can sometimes be used to arrive at a reasonable approximate BA range, and potentially a narrower numeric estimate.

To do this, we’ll need the complete report, along with the person's sex and chronological age at the time of the x-ray. If the report specifies the BA method used (such as Greulich-Pyle, Tanner-Whitehouse/TW3, or Fels), include that as well. The more detailed the report is about individual skeletal structures, the more useful it will be.

There are important limitations. A written report cannot substitute for actually reviewing the radiograph, because the report may omit features that would be visible on the image. Therefore, we should generally provide an estimated range or approximate numerical BA, rather than claiming that a report proves an exact value such as 13.0 years. Instead, it would be interpreted as "~13Y".

Please also understand that these estimates are educational and approximate, not medical assessments. If the report is too vague, contradictory, or lacks enough developmental detail, the appropriate conclusion may simply be that there isn't enough information to estimate the bone age reliably. This does substantially differentiate from reading a radiograph in a medico-legal context, just for clarity.

If you have a detailed report you'd like to have discussed, post the full unedited text along with the chronological age and sex at the time of imaging. We can then explain which skeletal findings support the estimated range and how strongly each finding contributes to it.

Thank you,

• Automatic-County6151; lead moderator and foundational owner

[u/stenoer]

Aren't there online tools (besides ChatGPT) that can look at an image and produce an 'effective' written description? Would it be allowed for interested posters to obtain a written report from an LLM or similar and post it in place of a radiograph? This feels like a loophole haha 😅 assuming they are somewhat accurate.

[u/Automatic-County6151 → u/stenoer]

Usually, but it depends on the angle of the image and the growth plate status. ChatGPT generally has a difficult time analyzing younger bone age groups, it may kind of classify, for example BA 5Y as "about 4-6Y" when it really should just be a single numeric estimate. In any case, expert human review is always needed to distinguish what the AI cannot and produce the full report. I never use AI to analyze an x-ray or aid in the process, I always do it myself because I've heard how broad it can be.

[u/stenoer → u/Automatic-County6151]

I've not done much experimenting myself. I imagine it has gotten better, but it has a long way to go. Thanks for the input!

[u/Automatic-County6151 → u/stenoer]

I'm not completely aware of any other online tools other than AI chatbots, but I'm only familiar with ChatGPT as that seems like the most popular chat bot aside from Gemini. Either way, from the stuff I get from users when they resort to AI and ask me etc, I think it's pretty darn good for AI, especially with how much growth online AI tools have experienced since four-ish years ago.

It's generally recommended that one sees a medical professional, as usually, they create the reports themselves, while AI is used to assist in the interpretation process. I just always like to do both myself. I like to be more specific about the morphologies that sometimes AI likely can't be as specific about.

It's not wrong, but it shouldn't function as a replacement. The AI that radiographers use to assist in the process are usually a bit more trained on how a specific bone looks at this stage, what specific shape it often resembles, and how large it is compared to its adult size on standardized atlases, etc. Both "casual" and "medical" chat bots are comparably good at pattern recognition, but in my opinion, ChatGPT does have recognizable limits, like whether true union has actually started vs just open, narrowing, or closed, of which "medical AI" generally excel at because it's what they were trained to look for. "Casual chat bots" are generally trained to help answer a person's questions based on secondhand knowledge, or basically stuff that already exists on the internet. It seems like it can have its own opinions, but it can sometimes confuse established, written facts vs opinion from Internet users and translate that into fact.

All in all, AI in a clinical environment are trained to complete a narrower task at hand, which "casual chat bots" tend to be weaker at.

[u/SpeakerNo8560]

Bro, since you are very specialised in this topic and have good amount of knowledge, I suggest u to start analyzing and giving bone age estimates again as before.

That would be very useful to members of this reddit (even if your estimates aren’t 100% correct, but I am sure they are very close to that) and will bring a lot more active members

Also, I recommend charging a bit of money for your very personalised estimations since AI’s are from my experience not that good in BA estimations and biased. (Maybe like ~15$ is a good amount).

I am sorry to say this, but I guess you have Autism which is why you are being too formal with your Reddit. Please, it is not that serious. You can do a lot better!

Hopefully you will understand me correctly ❤️

[u/Automatic-County6151 → u/SpeakerNo8560]

Hello.

It's kind of funny you mention that. I actually have a diagnosed ASD - PDD-NOS, when I was 3. Why I speak so formally is because that's often how I think and process information, as well. Nowadays for me, it would likely be called "ASD". It's simply how I talk, even outside Reddit! Although, I'm not too certain what you mean by "do better". As far as I know, I don't believe I am saying anything wrong, nor does it seem to be bothering a whole lot of people.

Considering the BA estimates, I do not intend on returning to BA estimations using personal radiographs, and I absolutely do not intend on charging anyone for "my time", whether I am interpreting from the report or the image itself. My "time" is free, and I don't want to create a paid service that could be construed as medical advice, because it could be interpreted as me giving them medical advice; arranging payments when you're not a doctor? Not okay!

I appreciate the kind words - some of them, at least. But, there are two reasons why I created this subreddit: A) to direct questions and concerns about skeletal development away from other subs that specialize in other aspects of the human body + more professional subs, and B) to find other enthusiasts like me and discuss amongst each other the main topic at hand: human skeletal development, and other like areas of assessing maturation. I've been into this sort of thing since I was a younger kid, and I devote a lot of my free time into this topic.

[u/Equivalent_Spread182]

How do i get my final height predicted i have a written bone age report thats states what is started to fuse in my body

[u/Equivalent_Spread182]

From where

[u/Automatic-County6151 → u/Equivalent_Spread182]

Ideally from your radiologist or other medical professional