n SA Journal of Radiology - Accuracy of bone assessments for verifying age in adolescents - application in sport : original article

Volume 11, Issue 2
  • ISSN : 1027-202X
  • E-ISSN: 2078-6778



Cheating often occurs in sports that are defined by age when older participants compete by falsifying their true age. In some cases administrators have responded by implementing a programme that attempts to establish true age by measuring the skeletal age of competitors. However, because the technique has not been validated in this context there is a risk that competitors who are the correct age may have been unfairly excluded from competition based on these tests.

To determine whether this technique has sufficient precision to be used effectively to identify 'age cheats'.
Twenty-three males (14 - 18 years) volunteered for the study. Their skeletal age was determined by means of an X-ray assessment of the hand and wrist undertaken by nine experienced radiologists.
The coefficient of variation of skeletal age for each subject predicted by the different radiologists ranged from 0% to 3.8%. The average difference between the chronological and skeletal ages was -0.5 years (95% confidence interval: -0.9 - -0.1 years), with a maximum under-prediction of 2.4 years and maximum over-prediction of 0.9 years. The magnitude of the error in the prediction did not seem to be related to either the mass or stature percentile of the subjects.
The technique of assessing skeletal age in an attempt to identify sports participants who are older than the prescribed age limit lacks the necessary precision. Until such time as an objective biological method is available to predict age more accurately, sport administrators should rather develop structures that can verify the accuracy of birth certificates.

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