Studies on the time frame for ossification of the medial epiphysis of the clavicle as revealed by CT scans

Abstract

The authors retrospectively analyzed 629 CT images of patients aged between 15 and 30 years produced during multiple trauma diagnostics at the Unfallkrankenhaus Berlin. For the purposes of this study, the authors reliably determined the ossification status of the medial epiphysis of the clavicle in 556 cases, using the classification of stages by Schmeling et al. In both sexes, stage 2 was first noted at age 15. In male patients, the earliest occurrence of stage 3 was noted at age 17, in female patients at age 16. Stage 4 was first achieved by both sexes at age 21. Stage 5 was first noted in female patients at age 21 and in male patients at age 22, which is 4 or 5 years earlier than was observed by a comparable study using conventional radiographs. The partial-volume effect in computed tomography using the thick slice scanning mode was discussed as a possible explanation for this early visualization. The question of how slice thickness affects the age intervals between ossification stages identified by CT examinations should be examined in additional studies.

Forensic Age Estimation in Unaccompanied Minors and Young Living Adults

“…Therefore reference values from dry bone studies should not be applied to assessments based on radiographs. Radiological methods to examine the medial clavicular epiphysis in living individuals are conventional radiography (CR) (Flecker, 1933;Galstaun, 1937;Jit & Kullkarni, 1976;, computed tomography (CT) (Kreitner et al, 1997(Kreitner et al, , 1998Schulz et al, 2005;Schulze et al, 2006;Bassed et al, 2010;Kellinghaus et al, 2010a, b), as well as new approaches using magnet resonance imaging (Schmidt et al, 2007;Hillewig et al, 2011) and ultrasoundsonography (Schulz et al, 2008b;Quirmbach et al, 2009;Schulz et al, 2010). While traditional classification systems differentiate between four stages of clavicle ossification (stage 1: ossification centre not ossified; stage 2: ossification centre ossified, epiphyseal plate not ossified; stage 3: epiphyseal plate partly ossified; stage 4: epiphyseal plate fully ossified), Schmeling et al divided the stage of total epiphyseal fusion into two additional stages (stage 4: epiphyseal plate fully ossified, epiphyseal scar visible; stage 5: epiphyseal plate fully ossified, epiphyseal scar no longer visible).…”

“…Since these studies did not discriminate results by sex, their forensic value is limited. In a CT study conducted by Schulz et al in 2005, presenting more cases and results discriminated by sex, the five stage classification by Schmeling et al was used. The earliest occurrence of stage 3 in females was noted at age 16 and in males at age 17.…”

The persistence of epiphyseal scars in the distal radius in adult individuals

“…Although many methods and approaches to skeletal age estimation exist [4][5][6][7][8][9][10][11][12][13], it is prudent to take certain conditions into consideration when selecting the most appropriate method to apply [14]. The applicability of a method or approach to a given case is dependent on a number of factors including the condition of the remains (e.g.…”

“…juvenile or adult); and the anatomical regions represented by the remains [14]. Assessments of age can be undertaken based on an examination of physical remains or through the analysis of images derived from medical imaging technologies including Computed Tomography (CT) [10,15], radiography [5,[7][8][9]16,17], ultrasonography (US) [13,18,19] or Magnetic Resonance Imaging (MRI) [20,21]. The application of medical imaging technologies to the process of skeletal age estimation facilitates an examination of not only the surface or gross morphology of the bone but also the underlying structure including trabecular organisation [22] and density [23], thereby allowing the examination of features or characteristics which may not be visible from gross inspection alone.…”

Comparative study on the effect of ethnicity on wisdom tooth eruption

“…Forensic age estimation in living subjects is a current focus of research interest [2,4,5,11,12,[14][15][16][17][18]. Wisdom tooth mineralization has been the main criterion used for dental age diagnosis in adolescents so far.…”