Can the Greulich and Pyle method be used on French contemporary individuals?

Forensic age estimation of living individuals has become increasingly important in forensic practice with the constant increase of migration movements to developed countries. The method of Greulich and Pyle is one of the most frequently used methods for age determination. The aim of our study was to verify the reliability of this method on a French contemporary population. We retrospectively analyzed 190 frontal hand and wrist radiographs of living subjects aged between 10 and 19 years (100 males and 90 females) performed in the Radiology Department of the University Hospital of Tours. These radiographs were compared with the Greulich and Pyle atlas to determine the skeletal age (SA) and to compare it to the chronological age (CA). We calculated the coefficient of correlation and the coefficient of determination for each sex group. The SA of our subjects was also inserted in the graphs provided by Greulich and Pyle in their atlas. Intra- and inter-observer variabilities were good, demonstrating the reproducibility and repeatability of the method. The correlation coefficients were high (0.98 for males and 0.93 for females) and comparable with published data. The mean difference between CA and SA was -2.29 months for males and -6.44 months for females, showing an overestimation of CA for both sexes. No statistical difference was found between CA and SA for both male and female samples. We concluded that the method of Greulich and Pyle can be used on a contemporary French population but not without caution because of a tendency for this method to overestimate age. A fully developed hand and wrist does not allow to state that the 18th year of life is completed beyond a reasonable doubt. We recommend using it in association with other methods.