ESPR Bone age for chronological age determination — statement of the European Society of Paediatric Radiology musculoskeletal task force group Lil-Sofie Ording Müller 1 & Amaka Offiah 2 & Catherine Adamsbaum 3 & Ignasi Barber 4 & Pier Luigi Di Paolo 5 & Paul Humphries 6 & Susan Shelmerdine 6 & Laura Tanturri De Horatio 5 & Paolo Toma 5 & Catherine Treguier 7 & Karen Rosendahl 8 Received: 19 February 2019 /Accepted: 1 March 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Radiologists are sometimes requested to determine a person’ s age based on skeletal radiographs. Critical reviews demonstrate that this cannot be done with sufficient accuracy with existing methods. Keywords Adolescent . Bone age . Children . Forensic imaging . Radiography . Skeletal maturation Introduction In some situations there is a need to verify or determine a per- son’ s chronological age. It might be unknown or intentionally falsified, e.g., in legal cases regarding child labour, sexual assault and prostitution, and sometimes for elite athletes. However, most commonly, age determination is needed for young asylum seekers. Every year, young unaccompanied asylum seekers ar- rive in European countries, many without knowing how old they are or unable to provide formal documentation of their age. To ensure that children receive their rights and that adults are not treated as children, it is necessary to assign a chronological age to these individuals. Evaluating skeletal maturation of hand de- velopment has been used for age assessment of asylum seekers in many countries. The method has been criticized for its lack of precision. “The Radiographic Atlas of Skeletal Development of the Hand and Wrist” by Greulich and Pyle is the most widely used atlas when age estimation is based on radiography of the hand. The Greulich and Pyle atlas was published in 1959 and was originally developed to assess the skeletal development of an individual with known chronological age to confirm normal skeletal development, to assess growth and growth potential and to estimate final height but not to assess chronological age [1]. Normal skeletal development is defined as a skeletal age within two standard deviations from the reference development stage for a given chronological age. This normal reference graph can- not automatically be reversed to find the reference interval for chronological age based on a given bone age. * Lil-Sofie Ording Müller lilsofie.ording@googlemail.com 1 Division of Radiology and Nuclear Medicine, Department of Paediatric Radiology, Oslo University Hospital Rikshospitalet, Po Box 4950, 0424, Nydalen Oslo, Norway 2 University of Sheffield, Academic Unit of Child Health, Sheffield Children’ s NHS Foundation Trust, Sheffield, UK 3 Pediatric Radiology Department, Paris-Sud University, Faculty of Medicine, and AP-HP, Bicêtre Hospital, Le Kremlin Bicêtre, France 4 Pediatric Radiology Department, Hospital Sant Joan de Déu, Barcelona, Spain 5 Department of Imaging, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy 6 Department of Radiology, Great Ormond Street Hospital, London, UK 7 Praticien Hospitalier, Service Imagerie Médicale Hopital Sud, Rennes, France 8 Haukeland University Hospital/University of Bergen, Bergen, Norway Pediatric Radiology https://doi.org/10.1007/s00247-019-04379-4