User Guide
How to capture, upload and interpret a hand-wrist radiograph for the best results.
1. A good hand-wrist radiograph
- •Left hand preferred; PA (posteroanterior) position with fingers slightly apart.
- •Hand flat and parallel to the cassette; all carpal bones including the wrist visible.
- •Avoid motion blur, jewelry or cast artifacts.
- •Balanced exposure: over/under-exposed images degrade the prediction.
2. Preparing and uploading files
- •Supported formats: JPG, JPEG, PNG, BMP, HEIC, WEBP and DICOM (.dcm). A progress bar is shown while uploading; you can cancel at any time.
- •If you upload DICOM, the system processes it automatically and makes it previewable; thanks to pixel-spacing metadata, measurements are also given in mm.
- •File size limit is 25 MB; re-export larger files.
- •If you use an institution, enter the Institution ID and optional file/image numbers for tracking.
- •If you know the patient's chronological age, enter it as years + months (optional); deviation and growth-rate calculations rely on it.
- •If you upload a phone screenshot, interface text is removed automatically, a portrait image is rotated and the wrist is preserved; the original file still gives a more reliable result.
3. Downloading a radiograph from e-Nabız
Radiographs taken in Turkey are stored in e-Nabız (the national health record). Downloading the original file instead of taking a screenshot lets the model run at full resolution and gives a more reliable result.
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Sign in to e-Nabız
Go to enabiz.gov.tr or open the e-Nabız mobile app and sign in with your e-Devlet password. For a child's record, pick the family member from the top menu.
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My Health History → My Radiology Images
In the left menu, under 'Sağlık Geçmişim' (My Health History) open 'Radyolojik Görüntülerim' (My Radiology Images; 'Görüntülerim' on mobile).
- 3
Find the examination
Select the hand-wrist radiograph by date and study name (e.g. 'El Bilek Grafisi PA'). The viewer opens.
- 4
Press 'Görüntüyü indir' (Download image)
Use the download icon in the viewer toolbar to save the file as PNG. If a DICOM download is offered, prefer it — measurements can then be given in mm.
- 5
Upload it to Age of Bones as a file
On the analysis page, use 'Choose File' to pick the downloaded PNG/DICOM, or drag and drop it.
- Do NOT take a screenshot: resolution drops, edges get cropped and interface text ends up in the image.
- The whole hand and wrist must be visible; an image with cut-off fingertips or wrist degrades the result.
On a phone, the downloaded file is usually in Files → Downloads (Android) or the Files app → Downloads (iPhone). When uploading, open that folder via 'Choose File' — pick from files, not from the photo gallery.
The uploaded image and result are stored encrypted and are visible only to you. Go to analysis →
4. Interpreting the result
- •The result shows estimated bone age (months/years), a likely range and estimated gender.
- •Evaluate the value together with chronological age and clinical findings.
- •On clear discrepancies, re-check image quality and positioning; the 'Heatmap' tab shows where the model looked.
- •Use 'Print' to add the result to a report or save as PDF.
5. How do I read the result?
The result screen shows more than a single number. Read these four elements together:
Likely range
The range next to the estimate (e.g. 147 months, likely range 138–156) is derived from the model's age distribution. A wide range means the model was unsure; the clinical margin of error is 7–11 months depending on the age band, and the range does not replace it.
Heatmap
The 'Heatmap' tab shows where the model looked most; the carpal bones and epiphyses are the expected areas. If it concentrates on a label, an edge or a cast, treat the result with caution. The 'Model input' tab is the actual model input.
Quality warnings
Warnings appear for screenshots, portrait uploads, low resolution, a wrist that is not visible or an uncertain age-group decision. If you see one, re-upload the original file where possible.
Re-run in the other age group
If the age-group decision looks doubtful, re-run the result in the other group (under / over 18) without using your quota (3 times per record). If the two results differ widely, physician assessment is decisive.
6. Institutional & admin use
- •Admins see all analysis records, images and statistics in the panel.
- •Institution IDs can be activated/paused and audited from the panel.
- •Login attempts and analyses are written to the security (audit) log.
- •Records can be exported as CSV.
7. Past analyses, comparison and feedback
- •The My Analyses page lists all your records; a printable report can be regenerated from any record, and the result page survives a refresh.
- •Tick the 'Compare' box on two records: the change in bone age, the growth rate between the two acquisitions (relative to calendar time) and a projected time to skeletal maturity are computed. The projection assumes linear growth; the clinical decision belongs to the physician.
- •The feedback form asks for two values separately: the bone age assessed by the physician and the patient's chronological age. Accuracy is measured against the physician's bone age.
- •If you learn the real age later, add it to the record from My Analyses; these reports let us measure the model's error in real use.
8. Account management
- •Change your password on the My Account page; if you forgot it, the 'Forgot password' link on the login page sends a time-limited reset link to your e-mail.
- •If you signed up with Google there is no password — sign in with Google.
- •'Download my data' gives you all your analyses and personal data as JSON.
- •'Delete my account' is permanent under KVKK: analyses, images and personal data are removed and cannot be restored. Download your data first.