In assessing skeletal maturity of the hand-wrist for bone age estimation (Greulich and Pyle atlas), which bone is considered to be the most reliable indicator of puberty-associated growth acceleration?

• A Pisiform ossification
• B Adductor sesamoid of the first metacarpophalangeal joint ✓
• C Fusion of the distal radius epiphysis
• D Ossification of the hook of hamate

Explanation

The adductor sesamoid bone at the first metacarpophalangeal joint (thumb MP joint) is a key indicator of pubertal growth in the Greulich and Pyle hand-wrist radiograph method. Its appearance correlates with Tanner stage 3 in males (about 13–14 years) and slightly earlier in females. In clinical orthodontics and endocrinology, the adductor sesamoid is used to time growth hormone therapy and orthopedic interventions. The pisiform ossifies at about 9–12 years, the hook of hamate at 9–12 years, and distal radius fusion occurs near skeletal maturity.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.