Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography

Abstract

Determination of the stage of ossification of the medial clavicular epiphysis is a crucial part of age estimation in criminal proceedings when evaluating individuals with completed hand ossification. In order to ensure a maximum of accuracy in forensic age estimation practise, it is recommended to perform thin-slice CT scans; but to date there exist no reference data on the bone development of the region in question based on thin-slice computed tomography. In this retrospective study, the authors evaluated thin-slice multidetector CT images of 592 individuals aged between 10 and 35 years produced in the University Hospital of Münster. The ossification status of the medial epiphysis of the clavicle could be reliably determined in 502 cases using the classification of stages by Schmeling et al. In male individuals, stage 2 was first noted at age 14, in female individuals at age 13. Stage 3 was first achieved by male individuals at age 17, by female individuals at age 16. The occurrence of stage 4 was first found in both sexes at the age of 21. In either sex, the earliest observation of stage 5 was at age 26. The findings are basically in line with those from the only CT-based study on the subject in question using the same classification of five stages, except from the fact that in the present study, stage 5 first occurs at age 26, which is 4 or 5 years later than what was found in the CT study using 7 mm slices in the majority of cases. This vast difference may be explained through the partial volume effect occurring with thick-slice CT images by a visual deception of the epiphyseal scar occurring with stage 4.

The persistence of epiphyseal scars in the distal radius in adult individuals

“…juvenile or adult); and the anatomical regions represented by the remains [14]. Assessments of age can be undertaken based on an examination of physical remains or through the analysis of images derived from medical imaging technologies including Computed Tomography (CT) [10,15], radiography [5,[7][8][9]16,17], ultrasonography (US) [13,18,19] or Magnetic Resonance Imaging (MRI) [20,21]. The application of medical imaging technologies to the process of skeletal age estimation facilitates an examination of not only the surface or gross morphology of the bone but also the underlying structure including trabecular organisation [22] and density [23], thereby allowing the examination of features or characteristics which may not be visible from gross inspection alone.…”

Medico-Legal Age Estimation in Living Individual from a Portuguese Population: Third Molar Mineralization

“…The complete ossification of medial clavicular epiphysis is, primarily, observed in ages of 21 years [21] or 22 years [22]. This result has a forensic importance, because the complete ossification allows classifying the majority of an individual, relatively, to the ages of legal relevance [20].…”

“…However, the results most be analyzed with precaution. The inter-group variability and the results from the group studied may be different in another group with a different status socio-economical and with a different impact on ossification [21]. The only study that contradicts is from Galstaun, from 1937, and he referred the complete ossification at the age of 19, however, there's no differentiation between partial and complete ossification, what, probably, influenced the results [cit in .…”

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

“…There are several radiological imaging techniques like conventional X-ray, CT, magnetic resonance imaging (MRI) and ultrasound which have been employed so far to study the clavicular ossification status [3,[6][7][8][9][10][11][12][13][14][15]. Conventional radiography has been successfully employed in this context in some studies [6][7][8], but the major problems faced in using this technique were suboptimal image quality and misinterpretation due to the overlapping of other skeletal parts like ribs, vertebrae and mediastinal soft tissue structures.…”

“…Computed Tomography has a very short scan time and it acquires high resolution data in a single breath hold. Thus all these problems (overlapping in X-ray and spatial resolution in MRI) were found to be eliminated by using computed tomography in some modern studies [3,[9][10][11][12]. CT also provides vastly better anatomical details of bony structures.…”