TW2 Method for Bone Age Assessment: A Comprehensive Guide

The TW2 (Tanner-Whitehouse 2) method for bone age assessment is a widely used technique to determine skeletal maturity. It involves the following process:

1. Obtain a hand and wrist radiograph of the patient.
2. Digitize the radiograph and upload it into the TW2 software.
3. The software will automatically identify and segment the bones in the image.
4. The user will then manually identify and label specific bones and landmarks on the image, such as the distal radius, ulna, and phalanges.
5. The software will then use a regression analysis based on the identified bones and landmarks to estimate the patient's bone age.
6. The estimated bone age is compared to the patient's chronological age to determine if there is any delay or advancement in skeletal maturation.
7. The results are interpreted and used in clinical decision-making, such as determining appropriate treatment for growth disorders or evaluating the progression of puberty.