Fig 1. Anatomy of hand and wrist (1) Radius (2) Ulna (3) Distal Epiphysis of Radius (4) Distal Epiphysis of Ulna (5) Trapezium (6) Trapezoid (7) Capitate (8) Hamular process of Hamate (9) Hamate (10) Triquetral (11) Pisiform (12) Lunate (13) Scaphoid (14) Sesamoid (M) Metacarpal (P) Phalanx A number of methods are available toassess the skeletal maturity of an individual. Th A. Use of hand-wrist radiographs. include: B, Evaluation of skeletal m uration using cer- vical vertebrae. C. Assessment of maturity by clinical and ra- diogeaphic examination of different stages of tooth development. Although a number of methods of skeletal maturity determination have been de- scribed, the use of hand-wrist radiographs has been the most widely accepted method HAND-WRIST RADIOGRAPHS ‘The hand - wrist region is made up of nu- merous small bones. These bones show a pre-~ dictable and scheduled pattern of appearance, ossification and union from birth to maturity. thus by merely comparing a patient’s hand wrist radiograph with standard radiographs that represent different skeletal ages, we will be able to determine the skeletal maturation status of that individual. \ number of methods have been de- scribed to assess the skeletal maturity us hand-wrist radiographs. The following are the