Objectives: Age determination is needed in administration of justice, employment, marriage, forensic investigation and identification. This cross-sectional study aimed to investigate the relationship between stages of epiphyseal union at the knee joint and chronological age. Methods:Anterior posterior and lateral knee radiographs of 100 males and 110 females aged 9-19 years were examined. Epiphyseal union was divided into five specific stages in the femur, tibia and fibula. Fusion was scored as stage 0: non-union, stage 1: beginning union, stage 2: active union, stage 3: recent union, and stage 4: complete union. Results:Mean age gradually increased with each stage of union and varied between males and females. A statistically significant difference in mean age was recorded between stages for the three epiphyses. Epiphyseal union occurred earlier in females than in males. A statistically significant difference was observed between the mean age of union for males and females for stages 1 and 2 for the femur, and stages 0, 1, 2 and 3 for the tibia and fibula. Conclusion:The results of this study indicate that radiographic analysis of the knee is a valuable alternative for estimation of chronological age.

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