Development of an Open-Source System for a Bone Age X-ray Language for Unaccompanied Foreign Minors

Bone age assessment is essential for evaluating skeletal maturity, especially in cases where chronological age is uncertain, such as in unaccompanied foreign minors. Traditional methods, such as the Greulich-Pyle atlas and the Tanner-Whitehouse system, while effective, often result in variability due to manual interpretation and are not fully adapted to ethnically diverse populations. Although automated systems are available, they are typically proprietary, expensive, and require programming expertise, which limits their accessibility. This paper introduces an open-source domain-specific language specifically designed for bone age estimation, offering a balance between flexibility and ease of use. The system provides a straightforward, user-friendly syntax, allowing healthcare professionals without programming knowledge to perform accurate bone age assessments. It integrates well-established bone age methodologies, such as the Greulich-Pyle and Tanner-Whitehouse systems, ensuring flexibility in its application. The system is developed using a test-driven development approach, which guarantees both accuracy and reproducibility in bone age assessments. By offering a customizable, open-source solution, this system reduces costs and eliminates the reliance on proprietary software. Its ability to simplify the bone age estimation process makes it a valuable tool in clinical and forensic settings, particularly for professionals involved in the assessment of unaccompanied foreign minors and other populations where accurate bone age determination is crucial.