Definition
- Risser 4
- <1cm change in height over 2 visits 6 months apart
- 2 years post-menarchal
- Bone age using
- is the degree of fusion of the iliac apophysis as seen on an anteroposterior (AP) radiograph.
- As stage 0 and stage 5 can appear similar, use age and long bone growth plates to differentiate:
- Grade 0 patients will still have open growth plates in most of the long bones and will likely be younger than 16 years (female) or 18 years (male)
- Grade 5 patients will have no open growth plates in the long bones
X-ray of hand and wrist Sanders maturity scale -
Risser grade
Grade | Features |
0 | no ossification centre at the level of iliac crest apophysis |
1 | apophysis under 25% of the iliac crest |
2 | apophysis over 25-50% of the iliac crest |
3 | apophysis over 50-75% of the iliac crest |
4 | apophysis over >75% of the iliac crest |
5 | complete ossification and fusion of the iliac crest apophysis |
- For LOIS before skeletal maturity
- Grade 5 patients will have no open growth plates in the long bones
- > 25° before skeletal maturity will continue to progress
- After skeletal maturity
- > 50° thoracic curve will progress 1-2° / year
- > 40° lumbar curve will progress 1-2° / year
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