Bone age assessment (BAA) of unknown people is one of the most important topics in clinical procedure for evaluation of biological maturity of children. BAA is performed usually by comparing an X-ray of left hand wrist with an atlas of known sample bones. Recently, BAA has gained remarkable ground from academia and medicine. Manual methods of BAA are time-consuming and prone to observer variability. This is a motivation for developing automated methods of BAA. However, there is considerable research on the automated assessment, much of which are still in the experimental stage. This survey provides taxonomy of automated BAA approaches and discusses the challenges. Finally, we present suggestions for future research. 1. Introduction Bone Age Assessment (BAA) often expressed as skeletal age assessment is a clinical method for evaluating the stage of skeletal maturation of a child [1]. BAA is not introducing a new field of skill in medicine science, as the eruption of the second molar was used in the Roman Empire as an indicator for calling young males for military service [2]. In the nineteenth century, age was estimated by dentists and tooth eruption was considered as a reliable method to detect the age of a child. In that era, the minimum bone age was calculated to be 7 years old in Britain [3]. However, some experts have opposed this method for the estimation of age. In 1846, Dr. Pedro Mata announced his concern about estimating age based on only tooth eruption [4]. Rontgen discovered X-rays in 1895 and his discovery made a revolution in the estimation of age for living subjects. This innovation based on radiography of the skeleton was used as a complement to tooth eruption [5]. In 1886, Angerer was the first person who stated that the carpus bone in the hand is an indicator for the estimation of age in young people [6]. The first systematic review of age variations in the carpus bone was published by Behrendsen in 1887 [7]. The researchers tried to define the age of the subject based on the radiologically defined maturation of the hand wrist bone [8]. Between 1950 and 1980, the most important methods for the estimation of age based on radiological analysis of the carpus bone were defined as Greulich and Pyle (GP) [9] and TW [10]. Both manual methods are time-consuming and prone to inter- and intraobserver variability. These are motivation for presenting computerised system of BAA [11, 12]. 1.1. Bone Age Assessment from Radiographs BAA is a radiological examination to determine the difference between the skeletal bone age and the chronological age (the
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