Age estimation of living individuals is of critical importance in forensic practice, especially because of the increased migration in developed countries. Recently, the contribution of magnetic resonance imaging (MRI) to age evaluation has been studied, as it seems to be an efficient technique to analyze growth plate maturation and epiphyseal fusion. We developed an MRI staging system for the distal tibial epiphysis and the calcaneal epiphysis and evaluated its reliability on 180 MRI scans of the ankle and foot in a sample of individuals aged from 8 to 25 years old. For both bones, the degree of union between the metaphysis and epiphysis was classified in three stages. Intra- and inter-observer variabilities were good, showing the validity and reproducibility of the method. Our results were consistent with data in the literature indicating that both epiphyses mature earlier in females than in males. Bayesian predictive probabilities were used to assess the validity of our method in estimating the age of an individual in relation to the 18-year threshold. MRI of the ankle and foot can be used in association with other methods to estimate age in living individuals.
The case of a ganglion cyst in the pulp of a fifth finger in an elderly woman initially mimicking a soft tissue tumor is described. Most typical sites of ganglion cysts are well documented at the wrist and in the vicinity of inter-phalangeal and metacarpo-phalangeal joints. In this case, ultrasonography (US) and magnetic resonance imaging (MRI) demonstrated a cystic lesion within the pulp of the fifth finger and indicated carpal osteoarthritis as the distant-and unexpected-origin of the lesion. The suggested diagnosis of ganglion cyst was confirmed by computed tomography arthrography (CT arthrography) of the wrist, which showed opacification of the cyst on delayed acquisitions after intra-articular injection into the mid-carpal joint, through the fifth flexor digitorum tendon sheath. The communications between the degenerative carpal joint, the radio-ulnar bursa, the fifth flexor digitorum tendon sheath and the pedicle of the cyst were well demonstrated.
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