Skeletal age determination of the hand: a comparison of methods

Abstract

Until final completion of maturation processes at the age of approximately 18 years, determination of the skeletal age of the hand plays a central role in forensic age diagnostics in living persons in criminal proceedings. In this process, assessment of hand radiographs relies primarily on the stage of development of the epiphyseal nuclei, the increase in size of the individual bones and of the hand skeleton as a whole, changes in the shape of the various skeletal elements and ossification of the epiphyseal plates. To achieve this, there are a variety of methodological approaches based on two different fundamental principles. The methods proposed by Greulich and Pyle, Thiemann et al. and Gilsanz and Ratib rank among the so-called atlas techniques, whilst the methods proposed by Tanner et al. and Roche et al. are classified as so-called bone-specific techniques. In order to be applicable in the field of criminal procedure, the methods of estimating the skeletal age of the hand developed with clinical aspects in mind must satisfy the demands of a high degree of estimate accuracy and good reproducibility of the estimated results. In the course of the present study, a study population of 92 persons was used to compare the above-mentioned atlas and bone-specific techniques for determining hand skeleton age in view of these qualitative criteria. Estimate accuracy was studied using Pearson's correlation coefficients, and weighted kappa coefficients were determined for studying the intra-and interobserver agreement of an estimate result. In the inter-method comparison, a basically good agreement was shown between the skeletal ages and the chronological age of the test persons on the one hand and the skeletal age diagnoses of one or of two examiners on the other. No general advantage of the methodological approach of the bone-specific technique was discernible in the course of comparison; in the female gender, particularly, the RUS2 and RUS3 score of the method of Tanner et al. proved unfavourable. For age estimation practice in criminal proceedings, the atlas methods of Greulich and Pyle and Thiemann et al. are particularly recommendable.

Accuracy of a cut-off value based on the third molar index: Validation in an Australian population

“…In fact, numerous studies have demonstrated that, after the adolescent period, age estimation is increasingly more difficult, as changes in the carpal bones are less readily discernable after 14-16 years of age [45]. Mineralization of the carpal bones begins at birth and lasts until approximately 13-14 years of age for girls and 15-16 years of age for boys; mineralization of the epiphyses of the ulna and radius continues until 16-17 years of age [46,47].…”

Age Estimation of Teenage Boys During Puberty

“…The most frequently employed method of bone age calculation is the Greulich &Pyle Atlas (16)(17)(18)(19). This atlas is a qualitative method using reference radiographic images of the left error which never exceeds 1 year for the 95% confidence interval.…”

Accuracy of MRI skeletal age estimation for subjects 12–19. Potential use for subjects of unknown age

“…The other issue, in forensic practice, is the importance of an accurate assessment of skeletal age [43] in all age groups, due to the fact that it may determine the future of young In all the aforementioned circumstances in which age assessment analysis for forensic purposes is required, the results can have very important consequences for individuals, as the aim is to determine if they should be assigned to childhood or adulthood. Inaccuracy in age estimation can negate an adult access to freedom.…”