Forensic Age Estimation Using Thin‐Slice Multidetector CT of the Clavicular Epiphyses Among Adolescent Western Chinese

Abstract

Reaching the age of 18 years is the most significant step for criminal proceedings in China. In this study, a population of 752 individuals was recruited to clarify how strong the chronological age relates to clavicular ossification status revealed by CT scans with 1 mm slice thickness in the West China Han population. Finally, the epiphysis was observed to commence fusion in females at 16.28 years and 16.74 years in males and be fully ossified by 25.97 years in females and 25.81 years in males. These findings suggested that ossification of medial clavicular epiphyseal cartilage can be used in age estimation for West China Han population with the age threshold of 18 years. By comparison with previous German studies, our results suggested that the pace of ossification of medial clavicular epiphyseal cartilage may be potentially affected by socioeconomic status.

CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults

“…Thus, it is better to provide age intervals instead of point estimates. In the present study, we found that 100% of subjects with stage IV and V ossification were ≥18 years similar to Pattamapaspong et al (15) and Zhang et al (16). Our study showed that subjects of both sexes with stage III B have 0% probability to be <18 years, and those with stage II have a probability of 79.3% to be <18 years.…”

“…In the present study, the ossification stages of medial clavicular epiphysis were defined using a modified version of the Schmeling classification (7), which is a widely accepted system (8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Previous studies showed that an individual can be estimated to be ≥18 years when complete ossification of epiphyseal cartilage (stage IV, V) is observed (8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…Previous studies showed that an individual can be estimated to be ≥18 years when complete ossification of epiphyseal cartilage (stage IV, V) is observed (8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Since stage III is a borderline to determine whether an individual is adult or not, we modified this classification to evaluate stage III epiphysis in more detail and divided stage III into two subgroups (stage III A, ≤2/3, ossification of epiphyseal cartilage; stage III B, >2/3 but not complete ossification of epiphyseal cartilage).…”

Evaluation of age estimation in forensic medicine by examination of medial clavicular ossification from thin-slice computed tomography images

“…We think that a change from stage 5 to stage 4 is possible and that the acceptability of the study data of Pattamapasong et al [33] to forensic age estimation should be discussed. Zhang et al [34] evaluated the clavicular medial epiphyses according to the four staging method, which were outdated already with the addition of a stage 5 by Schmeling et al [18] and especially by the introduction of substaging of the phases 2 and 3 by Kellinghaus et al [29]. Because they conducted evaluations according to the four staging method, they could not observe the difference of age minima between the stages 4 and 5.…”

“…Some age estimation studies have adopted an anatomical perspective by assessing ossification by direct skeletal inspection [7][8][9][10][11][12][13][14], whereas other studies have adopted a radiological approach by using technologies such as X-ray [15][16][17][18][19][20][21][22], CT [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], ultrasonography [35,[39][40][41], or magnetic resonance imaging [42,43]. CT imaging and projection radiography have significant advantages and are the modalities suggested by AGFAD [6].…”