How old is Bismack Biyombo? A doctor explains how accurately the wrist test could determine Biyombo’s age

How old is the hottest prospect in the NBA Draft, Bismack Biyombo?

David Aldridge took a stab at answering the question that could make the difference between Biyombo getting picked in the top-five and in the second round:

Biyombo says he’s 18, but as Sports Illustrated’s Ian Thomsen wrote over the weekend, NBA scouts and executives aren’t 100 percent sure, and Biyombo wouldn’t talk about it when asked.

"Question of the week here!," a team scouting director texted Sunday night. "No way to know for sure. I’m guessing he’s 21 or 22."

If that’s the case, it won’t be a big deal and Biyombo will go in the first round for sure. But an Eastern Conference GM said he heard rumors that Biyombo was anywhere from 23 to 26, which would obviously be a much different deal.

Jonathan Givony of Draft Express followed Aldridge’s reporting with more of his own:

Our research has revealed some slightly different information. Coaches who have worked with Biyombo earlier in his career while he was still in Congo think he’s “no older than 20 at most,” while Biyombo’s agent, Igor Crespo, has evidence that proves Biyombo is even younger.

Crespo says he took Biyombo to a specialist to conduct a bone age study immediately upon his arrival in Spain (Biyombo was reportedly 16). The study, as explained here involves taking x-rays of an adolescent’s wrist and hand to see if his growth plates are still open. Because the cartilage in Biyombo’s hand hadn’t fused at that point, the specialist came to the conclusion that he could be 16 or 17 at most, but not 18, when growth plates are expected to be closed.

This obviously rules out the possibility of Biyombo being five to eight years older than he’s listed, as the wild speculation we’ve seen recently on the Internet indicates. Crespo says he will willingly share these x-rays with any NBA team that requests them. One team we spoke with has already begun to evaluate the x-rays.

Doctor explains Bismack Biyombo’s age-determining wrist test

I talked to Dr. Ben Wedro, whom you might remember from his explanation of DeJuan Blair’s lack of ACLs, about how Biyombo’s alleged wrist test works. Wedro – read his blog and follow him on Twitter – said:

Bones in the body calcify at times. There are age ranges when bones in the body can be seen on x-ray. Similarly, there are age ranges when growth plates close. There are a variety of radiology textbooks that are used as reference guides to compare a patient’s x-ray with the book’s “norm”.

Aside from your situation, bone age is useful in determining when a patient enters puberty, perhaps trying to determine ultimate height and how much time there is left for a patient to grow.

The wrist is useful because there are many bones present that calcify at different and predictable times. However, once all the bones have developed and the growth plates closed, the concept of bone age is no longer useful.

There are some blood tests available that can help forensic pathologists try to roughly determine a patient’s age but it is only accurate to nine years  plus or minus.

That blood test obviously wouldn’t help here, so it looks like the wrist test is the best bet. I followed up with Wedro, asking his opinion of the test and whether there was a way to determine the x-ray showed Biyombo’s wrist, not someone else’s. I don’t know who’s seen the x-ray in the last two years, but I’d guess his professional teams have. So, it might not be too difficult to verify NBA teams are receiving the same x-ray taken that was taken two years ago. But how accurate is the test, and what if Crespo used a younger wrist-double in the first place? Wedro:

The wrist x ray would be reasonable accurate in estimating age.

The second question is harder. First, for what reason was an x ray taken two years ago? Was it for an injury or for another reason. Second, in most developed countries. A paper trail would be present that would link the patient to an x ray and its report. I do not know whether record keeping would be as precise as what we would expect to be normal in North America.

I explained that the x-ray was taken to determine his age, not because of an injury. With millions of dollars at stake, it wouldn’t shock me to hear Crespo used someone younger to imitate Biyombo. Wedro:

Unless there was something distinctive about one of the bones, like if there was a previous break that healed poorly, it might be difficult to make a definitive statement.

In the US, the paper trail might include a physician order, a radiology reading report, a bill for the services and they all would have identifying information like a name, birthdate, medical record number, address, etc.

So, unless Biyombo has a distinctive mark on his bones, which might cause a whole new set of issues, this probably comes down to how much you trust Spanish medical records, Crespo and Biyombo.

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