Determining the Ossification Status of Sternal End of the Clavicle using CT and Digital X-ray: A Comparative Study

OP, Khandelwal N Jasuja

doi:10.4172/2157-7145.1000223

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…The practice of CT of the MCE with arms down may represent a holdover from the time when age estimations were performed with x-rays of the clavicle (taken in an arms-down position) and should be revaluated in the current era of CT. In this context, one must keep in mind that many CT reference studies for FAE are based on clinical CT scans, often the chest [ 24 , 36 , 37 , 42 , 46 , 48 , 49 , 51 , 52 , 58 ]—scanned with arms raised—and therefore, a change in practice to CT of the clavicle with arms-up for age estimation is unlikely to have an effect on staging of MCE ossification. Recently, Tozakidou has already demonstrated how CT of the MCE for FAE with arms up has the potential to decrease effective dose and increases image quality [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis—a systematic review

Ruder,

Kuhnen,

Zech

et al. 2023

Int J Legal Med

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The AGFAD (Arbeitsgemeinschaft für Forensische Alterdiagnostik, Study Group on Forensic Age Diagnostics) has published several recommendations regarding both technical aspects of computed tomography (CT) of the medial clavicular epiphysis (MCE) and the process of reading and interpreting the CT images for forensic age estimations (FAE). There are, however, no published recommendations regarding CT scan protocols and no dose reference values for CT of the MCE. The objective of this analysis was to assess adherence to AGFAD recommendations among practitioners of FAE and analyse reported dose-relevant CT scan parameters with the objective of helping to establish evidence-based dose reference values for FAE. A systematic literature search was conducted in PubMed and in Google Scholar with specific MeSH terms to identify original research articles on FAE with CT of the MCE from 1997 to 2022. A total of 48 studies were included. Adherence to AGFAD recommendations among practitioners of FAE is high regarding the use of Schmeling main stages (93%), bone window (79%), ≤ 1 mm CT slices (67%), axial/coronal CT images (65%), and Kellinghaus sub-stages (59%). The reporting of CT technique and CT dose-relevant scan parameters is heterogeneous and often incomplete in the current literature. Considering the success achieved by the AGFAD in creating standards of practice of FAE in living subjects, there is potential for the AGFAD to establish standards for radiation protection in FAE as well.

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Section: Discussionmentioning

confidence: 99%

Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis—a systematic review

Ruder,

Kuhnen,

Zech

et al. 2023

Int J Legal Med

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“…The weakest point of the clavicle is the junction between its curvatures, and fractures commonly occur by falling on the outstretched hand. 3 The secondary ossification center is found at the medial end as the only epiphysis of the bone end. This epiphysis is the last to ossify and fuse at the ages of 18 and 20 years and at the end of 25 to 26 years, respectively.…”

Section: Introductionmentioning

confidence: 99%

Employing Computed Tomography to Assess Clavicle Symmetry in Healthy Adults in the Indian Population of Dakshina Karnataka

Barde,

Sharma,

Yadav

2024

Journal of Health and Allied Sciences NU

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Background The S-shaped collar bone lies horizontally at the root of the neck and is one of the most common bones to fracture. The symmetry of the clavicle bone differs between males and females, so the present study was conducted to assess the symmetry of the clavicle in healthy adults of the Indian population in the Dakshina Karnataka region. Methods The data for this cross-sectional study were retrospectively collected from 138 adult patients who all underwent chest computed tomography (CT) for clinical reasons. Patients younger than 18 years and those with bony fractures, trauma, or other deformities were excluded. Axial chest CT images were used to trace the anatomy of the clavicle. The curved planar reconstruction technique was used to trace the maximum length of the bilateral clavicle. Results There were 138 patients of both sexes. Patients ranged in age from 20 to 80 years. The chi-square test was used to investigate whether sex and clavicle symmetry were related. In women, bilateral symmetry and asymmetry were 42.5 and 41.2%, respectively, while in men, they were 57.5 and 58.8%, respectively; hence, there was no significant correlation (p-value = 0.877) between clavicle symmetry and sex. A linear-by-linear association test was performed to ascertain the relationship between the variance in clavicle symmetry and age. It was noted that 51 individuals had asymmetry and 87 had symmetry. The patients were further divided into three age groups. There were 34, 67, and 37 individuals in the 20 to 40, 41 to 60, and 61 to 80 years age groups, respectively. Clavicle symmetry was 27.6% in the 20 to 40 and 61 to 80 age groups and 44.8% in the 41 to 60 age group. The percentages of asymmetry were 19.6, 54.9, and 25.5% in the 20 to 40, 41 to 60, and 61 to 80 years age groups, respectively, with no correlation between age and clavicle length symmetry (p-value = 0.643). Conclusion Regardless of age or sex, the population under study had symmetric clavicles. As a result, the assumption of symmetry may be accepted in some clinical scenarios, such as simple fractures, but caution should be exercised when designing fixatives and surgical cases.

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Determining the Ossification Status of Sternal End of the Clavicle using CT and Digital X-ray: A Comparative Study

Cited by 2 publications

References 14 publications

Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis—a systematic review

Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis—a systematic review

Employing Computed Tomography to Assess Clavicle Symmetry in Healthy Adults in the Indian Population of Dakshina Karnataka

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