Estimating legal age based on fusion of The proximal humeral epiphysis

Abstract

The increasing demand which requires ascertaining the legal age of undocumented individuals who reach the various countries of the European Community means that new lines of research must be developed which help respond to questions posed by the Justice Administration. For this reason, this study has been designed on the basis of fusion times of the proximal humeral epiphysis. Moreover, the ultrasound scan has been used as the diagnostic method. It is a non-invasive technique, unlike the radiograph, which is used under current standards for the forensic diagnosis of age. Used as a study sample were the ultrasound images of the proximal humeral epiphysis among 221 individuals belonging to the Spanish population, of both genders, of ages ranging from 5 to 30 years. All of the images were classified into 6 stages of fusion based on the morphology of each. The results display differences among the six age groups proposed for each of the stages of fusion and are of great interest from the perspective of enforcing the Spanish Criminal Law Act on Minors, because Stage 4 would mean that the person being studied is under the age of 16 years in the case of males and 15 years in the case of females. These results, coupled with the use of ultrasound as a non-invasive diagnostic technique, make this study a very useful method when the use of radiographs is not possible.

Forensic age estimation of living individuals: a novel bibliometric approach to the literature review

“…2017). The four studies published using ultrasound included one paper on the ossification of the fibular distal epiphysis (Schulz, Schiborr, Pfeiffer, Schmidt & Schmeling 2013), one paper on the ossification of the olecranon of the ulna (Schulz, Schiborr, Pfeiffer, Schmidt & Schmeling 2014), one on the ossification of the greater trochanter of the femur (Schmidt, Schiborr, Pfeiffer, Schmeling & Schulz 2014), and one on the fusion of the proximal humeral epiphysis (Sánchez, Codinha, García & Sánchez 2017). For MRI, seven papers included two publications on age estimation using distal tibial epiphysis and calcaneus (Ekizoglu et al.…”

“…Using CT scan as imaging modality, publications included three studies on the sphenooccipital synchondrosis (Bassed, Briggs & Drummer 2010;Can et al 2014;, one study using the first rib (Moskovitch et al 2010), and one study on the scapula (Nougarolis et al 2017). The four studies published using ultrasound included one paper on the ossification of the fibular distal epiphysis (Schulz, Schiborr, Pfeiffer, Schmidt & Schmeling 2013), one paper on the ossification of the olecranon of the ulna (Schulz, Schiborr, Pfeiffer, Schmidt & Schmeling 2014), one on the ossification of the greater trochanter of the femur (Schmidt, Schiborr, Pfeiffer, Schmeling & Schulz 2014), and one on the fusion of the proximal humeral epiphysis (Sánchez, Codinha, García & Sánchez 2017). For MRI, seven papers included two publications on age estimation using distal tibial epiphysis and calcaneus (Ekizoglu et al 2015;Saint-Martin et al 2013), one using only the distal tibial epiphysis (Saint-Martin et al 2014), one using the spheno-occipital synchondrosis (Ekizoglu, Hocaoglu, Can, Inci & Aksoy 2016), one using the development of the manubrium (Martínez Vera et al 2017), and two on the proximal humeral epiphysis (Ekizoglu, Inci, Ors, Hocaoglu, et al 2019;Ekizoglu, Inci, Ors, Kacmaz, et al 2019).…”

Ultrasound in legal medicine—a missed opportunity or simply too late? A narrative review of ultrasonic applications in forensic contexts

“…In all other regions, full ossification is reached earlier also compared to the medial clavicle epiphysis, e.g., 13.5 years (females) and 14.5 years (males) for the trochanter major of the femur. Sánchez et al examined the proximal humeral epiphysis and determined six stages of development [ 50 ]. A full fusion is related to an age of at least 17 years in both sexes.…”

Creation and Validation of a Shorthand Magnetic Resonance Imaging Bone Age Assessment Tool of the Knee as an Alternative Skeletal Maturity Assessment

“…As previously demonstrated by the hand shorthand, this shorthand method could also be posted on the clinic wall or easily displayed in a search engine image query. 6 This may be of benefit not only in orthopaedic surgery but also in other fields of surgery, medicine, forensic science, cultural anthropology, and immigration law, 5,11,12,16 but this must be balanced with the cost and logistical constraints of performing MRI. At our institution, we do not perform MRI solely to assess bone age; we use this bone age assessment technique for patients who require a knee MRI scan as part of their diagnostic workup.…”