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TW2 and TW3 bone ages: time to change?
  1. M Lynn Ahmed1,
  2. Justin T Warner2
  1. 1Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK
  2. 2Department of Child Health, University Hospital of Wales, Heath Park, Cardiff, UKJ T Warner, Department of Child Health, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK; Justin.warner@cardiffandvale.wales.nhs.uk

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In 1983, the Tanner−Whitehouse 2nd edition (TW2) system of bone ageing was published and has remained the most widely used system in the UK.1 Several studies have shown that children are maturing more rapidly and reaching a given skeletal maturity score (SMS) at an earlier chronological age.2 In view of this finding, Tanner and colleagues published a revised 3rd edition for bone ageing in 2001 (TW3).3 This updated the relationship of the SMS to bone age to deal with the secular trend that had occurred in skeletal maturation since the previous edition. However, this new …

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