Sanders skeletal maturity staging system^[1]

Peak height velocity occurs at the beginning of Sanders stage 3, depicted in the figure. The characteristic finding in stage 3 is that most epiphyses cap their metaphyses. The capping is a small bend over the metaphyseal edge (arrows). In the metacarpals, the second through fifth heads (arrowheads) are wider than the metaphyses. Key features of stages 1 to 8 are described in the table.

References:

Sanders JO, Khoury JG, Kishan S, et al. Predicting scoliosis progression from skeletal maturity: A simplified classification during adolescence. J Bone Joint Surg Am 2008; 90:540.
Cheung PWH, Cheung JPY. Sanders stage 7b: Using the appearance of the ulnar physis improves decision-making for brace weaning in patients with adolescent idiopathic scoliosis. Bone Joint J 2021;103-B:141.

Illustration from: Sanders JO, Khoury JG, Kishan S, et al. Predicting scoliosis progression from skeletal maturity: A simplified classification during adolescence. J Bone Joint Surg Am 2008; 90:540. DOI: 10.2106/JBJS.G.00004. Copyright © 2008 The Journal of Bone and Joint Surgery, Inc. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.

Graphic 119094 Version 3.0

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Sanders skeletal maturity staging system[1]

Sanders skeletal maturity staging system^[1]