Preliminary exploration of ultrasonic parameters for predicting final adult height in children

This study aimed to develop an ultrasonic-based predictive model for final adult height in children. This prospective follow-up study was performed from January 2021 to January 2025. All participants were randomly divided into training and validation sets in a ratio of 7:3. A multiple linear regression model was developed to predict final adult height, using baseline height (height at ultrasonic assessment), sex, and skeletal maturity scores (SMS) as independent variables. The predictive accuracy of the ultrasonic model for final adult height was then evaluated in the validation set and compared with the radiographic TW height prediction method and Bayley–Pinneau (BP) method. A total of 70 children were included in this study, with a mean age of 12.6 ± 1.3 years at the time of ultrasonic assessment. The cohort comprised 50 children (23 boys) in the training set and 20 children (12 boys) in the validation set. The ultrasonic model incorporating SMS demonstrated a multiple coefficient of determination (R2) of 0.88, with a root mean square error (RMSE) of 2.2 cm for predicting total height gain in children. In the validation set, the ultrasonic model exhibited a mean prediction bias of − 1.1 ± 2.7 cm (95% CI − 2.3 to 0.2 cm) relative to measured final adult height, which is comparable to TW method (1.1 ± 4.5 cm, 95% CI − 1.0 cm, 3.2 cm; p = 0.172). While the BP method demonstrated significantly greater prediction errors (− 5.2 ± 3.9 cm, 95% CI − 7.1 cm, − 3.4 cm; p = 0.003). The ultrasonic SMS model predicts adult height with accuracy comparable to TW method and superior to the BP method, presenting a promising radiation-free alternative pending external validation.