Age dependence of epiphyseal ossification of the distal radius in ultrasound diagnostics

Abstract

By determining the ossification stage of the distal radial epiphysis, it is possible to gain important information to help clarify the question of whether various legally relevant age limits have been exceeded. Any examination of the hand by means of projection radiography such as that used in conventional skeletal age diagnostics is strictly regulated for reasons of radiation hygiene. In many areas of the law, there are no basic legal provisions authorising the performance of X-ray examinations. The present study examines the applicability of ultrasound diagnostics in assessing ossification processes in the distal radius. To this end, the ossification stages of the distal radial epiphysis were determined in 306 female and 309 male study participants aged between 10 and 25 years. In the female gender, ossification stage III was determined at an age of 13.4 years at the earliest, and ossification stage IV at 15.0 years at the earliest. In the male gender, ossification stage III was not observed until 14.3 years, and ossification stage IV not until 15.2 years. In the practice of forensic age estimation in living persons, sonographic examination of the distal radius in areas of application with no legal basis for authorising X-ray examinations makes it possible to improve the accuracy of age diagnosis by including criteria of skeletal maturation. In view of the existing legislative basis for the use of X-rays on human subjects, the exposure of individuals to radiation can be minimised.

Virtual anthropology: useful radiological tools for age assessment in clinical forensic medicine and thanatology

“…This exposure raises ethical concerns, even if the individual gives consent before the examination takes place. Bearing this in mind, non-invasive imaging procedures such as ultrasound examination (US) and magnetic resonance imaging (MRI) have recently been applied to minimize radiation exposure of the individual examined [11][12][13][14][15]. It is because of the need to compare the results with those of previous plain X-ray studies that anatomical areas such as the sternal end of the clavicle, the hand and wrist, and the iliac crest have been studied.…”

“…Other studies yielded less conclusive results [19]. Like the Greulich and Pyle method, ultrasonography of the radial epiphysis appears to be particularly accurate up to the 14-year-old threshold [14]. --The medial end of the clavicle was the subject of two main studies, using a 4-stage classification created for radiography [20,21].…”

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

“…Computed tomography (CT) and magnetic resonance (MR) imaging are also commonly used methods, and their cost has decreased due to technological development. Additionally, technical advances have allowed for the development of high-resolution ultrasonography, which involves no radiation exposure and is costeffective [5][6][7][8]. The guidelines of the Study Group on Forensic Age Diagnostics propose physical examination, X-ray examination of the left hand, and dental examination for forensic age estimation.…”

Age Estimation in Living Individuals

“…Schmidt et al have recently published ultrasound studies on the chronological process of ossification of the epiphyseal plates of the distal radius and of the iliac crest (Schmidt et al 2011b(Schmidt et al , 2011c. without a threshold dose.…”