The Risser Sign: A Critical Analysis.Little, David G. M.B.B.S.; Sussman, Michael D. M.D.Journal of Pediatric Orthopaedics: September/October 1994 Article: PDF Only Abstract Abstract Summary: Orthopedic surgeons commonly use the Risser sign to estimate skeletal maturity; however, the data presented in the orthopedic literature supporting the accuracy of the Risser sign in estimating skeletal maturity do not stand up to critical statistical analysis. The Risser sign is less accurate than chronologic age as a predictor of skeletal age and should not be used as a substitute for a hand and wrist radiograph in most cases. The Risser sign is also no better a predictor of scoliosis progression than is chronologic age. (C) Lippincott-Raven Publishers.