Abstract
Variation in the rate at which children mature is familiar to all clinicians dealing with growth. Choronological age gives little indication of physiological development and the TW II method of assessing skeletal maturity was developed as a means of obtaining information about the biological age of children and maturational changes. In practice the method requires sequen tial assessment of twenty bones of a carefully positioned radiograph of the left hand and wrist.
Each bone is rated independently and scores assigned depending on written criteria. Some difficulties arise when interpreting the criteria of the system. The definition of terms such as capping and fusion, will be discussed, as will problems encountered from poor positioning of the radiograph. The aim is to give practical advice in the use of the system, and to look at some of the problems.
