Computed tomography evaluation of the iliac crest apophysis: age estimation in living individuals

Abstract

Determination of the ossification properties of the iliac apophysis is important not only in the clinical evaluation of patients undergoing orthopedic surgery but also in age estimation studies for forensic purposes. The literature includes both anthropological and radiological (conventional radiography, ultrasonography, and magnetic resonance imaging modalities) investigations of the different staging systems used for these purposes. In this study, we assessed the utility of computed tomography (CT) of the iliac crest apophysis in estimating forensic age. CT scans of the iliac crest apophysis of 380 patients (187 females, 193 males, and 10-29 years of age) were evaluated according to the four-stage system. Further subclassification did not give data properly due to the reference length measurement of the iliac wing with CT. Thus, in our series, stage 2 was first seen in 12 years of age and stage 3 in those 14 years of age in both sexes and on both sides of the pelvis. Stage 4 was first seen in 17 years of both sexes but only on the right side; on the left side, it appeared in females 18 years of age and in males 17 years of age. Present data was found consistent with previous pelvic radiographic findings. First seen ages for stage 2 and 3 are 12 and 14 years respectively which presented valuable information for legally important age thresholds. However, disadvantages of CT, including high-dose radiation exposure to gonads, the difficulty of evaluating the iliac crest, and the age boundary of 17 years, could make this method infeasible, as compared with hand wrist and pelvic radiographic methods. CT of the iliac crest has probably a greater utility where preexisting CT scans of the pelvic region are available, and it may be considered as a supportive method for age-estimation purposes.

Computed tomography-based age estimation of illiac crests calcification in 10-29 year-old individuals

“…However, the minimum age at the left side of the pelvis for girls and boys was 18 years and 17 years, respectively. [5] These results are in good agreement with those of the present study. This study showed that the determination of bone age with Kreinter's criteria is possible in girls up to the age of 18–20 years.…”

“…It is possible to investigate the details of apophysis through tomography by evaluating the clavicle ossification. [56789] According to the Study Group on Forensic Age Diagnostics (AGFAD), the radiological evaluation of the left hand, teeth, or clavicle is used to determine the actual age, provided that hand ossification is complete[135101112]…”

“…In previous studies, ultrasound,[1516] MRI[17] and tomography. [151819] were used to determine the legal age based on the ossification of the illiac crest. However, these studies have used different methods to evaluate the bone age and there is no standardized method for age determination.…”

Random forest age estimation model based on length of left hand bone for Asian population

“…Therefore, it will be a waste of money and time. There are many reported methods that used bones for age estimation and they are subdivided into three main categories: image processing [29][30][31], by comparing with bone age atlas [32][33][34], and statistical regression analysis [35][36][37][38]. As being compared with the atlas, as the name proposes, X-ray image of the subjects are being made comparison with an atlas which contains a set of radiographs of identified gender and age.…”

The forensic staging system for iliac crest apophysis provides more detailed clinical follow-up data than Risser classification

“…Ossification of the iliac crest apophysis has been also used for a long time by forensic experts and anthropologists, who use different staging methods, to determine the age of a person based on direct analysis or X-ray evaluation (13,14) . Iliac crest apophysis has been evaluated with X-rays (15)(16)(17) , ultrasonography (USG) (18)(19) , magnetic resonance imaging (MRI) (18) , and computed tomography (CT) (20) to determine the age, and thus the legal and civil responsibilities, of living individuals, and to verify that athletes have the appropriate licenses.…”