Magnetic resonance imaging of distal tibia and calcaneus for forensic age estimation in living individuals

Abstract

In recent years, methods by which to decrease radiation exposure during age estimation have gained importance and become a main research area in the forensic sciences. Imaging tools such as X-ray and computed tomography (CT) are accepted as the main diagnostic methods for evaluation of the epiphysis in living individuals; however, radiation exposure and superimposition are the main disadvantages of these techniques. Magnetic resonance (MR) imaging provides an advantage in terms of preventing radiation exposure. In this study, we performed an MR analysis of the degree of fusion of the distal tibia and calcaneal epiphysis and investigated the utility of this technique in the Turkish population. Using the three-stage method described by Saint-Martin et al., we retrospectively evaluated 167 MR images (97 males, 70 females; mean age, 17.7 ± 4.8 years for males and 17.6 ± 4.9 years for females; age range of all subjects, 8-25 years). Intraobserver and interobserver evaluation showed good repeatability and consistency of this method. Stages 2 and 3 ossification of the distal tibial epiphysis first occurred at age 14 and 15 years in males and 12 and 14 years in females, respectively. Stages 2 and 3 ossification of the calcaneal epiphysis first occurred at age 14 and 16 years in males and 10 and 12 years in females, respectively. When performed alone, MR analysis of the distal tibial and calcaneal epiphysis offers limited information for forensic age estimation. However, we suggest that MR analysis can be used as a supportive method when it is necessary to avoid repeated radiation exposure.

Forensic age diagnostics by magnetic resonance imaging of the proximal humeral epiphysis

“…According to current human development index data [51], the Turkish population falls in the category of low socioeconomic status. Some differences in minimal age limits reported in previous studies of the Turkish population include medial clavicle ossification and the proximal femoral and distal tibial epiphyses [22,52,53,54]. Consequently, a low socioeconomic status should be taken into consideration when evaluating the results of the current study.…”

“…Radiation exposure in the pediatric age group has recently raised ethical concerns [9,10,11]. Therefore, studies have been conducted on the use of ultrasonography of the distal radius [12], iliac crest [13], distal fibula [14], and medial clavicle epiphysis [15] and magnetic resonance imaging (MRI) of the medial clavicle epiphysis [16,17,18,19], distal tibia and calcaneus [20,21,22], proximal tibial epiphysis [23,24], iliac crest [25], hand and wrist [26,27,28,29,30,31,32,33], and distal femur [24,34,35] to estimate age in different populations.…”

Applicability of T1-weighted MRI in the assessment of forensic age based on the epiphyseal closure of the humeral head

“…The last parts of the appendicular skeleton to convert are the proximal humeral and femoral metaphyses [14]. Epiphyseal closure has been studied to reveal minimal age limits for forensic age estimation using different articulations, imaging modalities and scoring systems [1,[15][16][17][18][19]. The recommended methods for age estimation of living individuals by several forensic associations include physical and radiological examination of children and adolescents [6][7].…”

“…However, in recent years, radiation exposure in the pediatric age group has caused ethical concerns [20]. Therefore, developmental studies of living individuals have shifted to non-invasive modalities, such as ultrasonography [21][22][23] and magnetic resonance imaging (MRI) [15][16][17][24][25][26][27][28].…”

“…MRI indeed offers a remarkable insight into the dynamic process of skeletal growth and maturation, as demonstrated by an increasing number of studies in children and adolescents in recent years [15][16][17][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The vast majority of these studies focused on the clavicle, hand and wrist, producing large 6 reference databases for different populations.…”