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

Furkan Ufuk · Kadir Ağladıoğlu · Nevzat Karabulut

38 citations0/0 files storedDiagnostic and Interventional Radiology

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Forensic Anthropology and Bioarchaeology Studies Child Abuse and Related Trauma Shoulder and Clavicle Injuries

Abstract

PURPOSE: We aimed to investigate the use of computed tomography (CT) staging of the medial clavicular epiphysis ossification in forensic bone age determination, and find a CT criterion to determine whether an individual is adult or not. METHODS: Chest CT and pulmonary CT angiography exams of 354 patients between 10 and 30 years of age (mean, 21.4 years) were retrospectively evaluated for epiphyseal ossification phase of the bilateral medial clavicles (708 clavicles) and compared with the sex and chronologic age of the individuals. The ossification phase of the medial clavicular epiphyses was classified from stage I to stage V using a modified staging system. RESULTS: Epiphyseal ossification center appeared from 11 to 21 years of age. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the ages of 18 and 19 years for male and female individuals, respectively. The probability of an individual being ≥18 years old was 70.8% in stage III A and 100% in stages III B, IV, and V in females and males. CONCLUSION: CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage III B can be used as a criterion to make the prediction that an individual is older than 18 years.

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References

1985Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females 2004Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography 2006Age estimation 1957SKELETAL AGE CHANGES IN YOUNG AMERICAN MALES ANALYSED FROM THE STANDPOINT OF AGE IDENTIFICATION 2010Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans 1998Bone age determination based on the study of the medial extremity of the clavicle 2005The influence of slice thickness on assessment of clavicle ossification in forensic age diagnostics 2013The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study

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2019Guidelines for best practice: Imaging for age estimation in the living 2016Evaluation of the medial clavicular epiphysis according to the Schmeling and Kellinghaus method in living individuals: A retrospective CT study 2016Evaluation of the ossification of the medial clavicle according to the Kellinghaus substage system in identifying the 18-year-old age limit in the estimation of forensic age—is it necessary?

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