Recently, determination of skeletal age, defined as the assessment of bone age, has rapidly become an important task between forensic experts and radiologists. The Greulich-Pyle (GP) atlas is one of the most frequently used methods for the assessment of skeletal age around the world. After presentation of the GP approach for the estimation of the bone age, much research has been conducted to examine the usability of this method in various geographic or ethnic categories. This study investigates on a small-scale and compares the reliability of the GP atlas for assessment of the bone age for four ethnic groups - Asian, African/American, Caucasian and Hispanic - for a different range of ages.
Studies on the wrist joint have shown two types of the carpal bone lunate. In type II lunate there is a facet on the medial side of the lunate for articulation with the proximal pole of the hamate; such a facet is absent in type I lunate. Type II lunates have different kinematics, are more prone to clinically relevant degenerative changes in the hamato-lunate joint and are an uncommon cause of ulnar-sided wrist pain. Ninety plain radiographs showing postero-anterior views of the wrist (52 right and 38 left wrists) were studied in a population of Malays from Malaysia (mean age 48 years; age range 23 to 67 years) to determine the incidence of type I and type II lunates. Our findings were compared with those in other reports in the literature. In Malays, only 24 wrists (26.7%) showed a type II lunate compared to a reported incidence of 50% or more in populations from the Western world. Such a low incidence of type II lunate has not been reported before and may represent a genetic variation in Malays. Consequently, osteoarthritis of the hamate or lunate may play a less significant role in causing ulnar-sided wrist pain in Malays. In conclusion, the prevalence of type II lunate might vary in different population groups and further studies could be necessary to confirm this observation.