Forensic Age Estimation of Individuals from Computed Tomography Analysis of Medial Clavicular Epiphysis in Pakistani Population

J Coll Physicians Surg Pak. 2023 Apr;33(4):385-389. doi: 10.29271/jcpsp.2023.04.385.

Abstract

Objective: To determine the association of chronological age through ossification of the medial clavicular epiphysis using computed tomography (CT) scan.

Study design: An Observational study. Place and Duration of the Study: Dow Institute of Radiology, Dow University Hospital, Karachi, Pakistan, from February 2021 till October 2021.

Methodology: Subjects aged 10-35 years of either gender reported without any clavicular trauma or fracture, no known chronic illness or malignancy, or no congenital bony abnormalities, or any prior surgical intervention to the sterno-clavicular region were included. The fusion of maturity of medial clavicular epiphyses was evaluated on either side by using the five-stage classification system reported by Schmeling.

Results: Of 200 patients, a significant increase in the age of the patients was observed with respect to the increase in the stages (p <0.001). When stratified on the basis of gender, a significant increase in age was also observed with respect to the increase in stages (p <0.001). Stage 4 was observed in majority of the patients, i.e., 81 (40.5%), followed by stages 2 and 3 in 35 (17.5%) each, stage 5 in 32 (16%), while stage 1 was observed in 17 (8.5%) patients. An insignificant difference of age was observed with respect to the gender of the patients (p= 0.472, 95% CI -2.91 - 1.35).

Conclusion: The fusion of the medial clavicular epiphysis showed a considerable degree of variability. Fused clavicles at stage 4 could be observed at age 22 years or less in males while at 21 years or less in females.

Key words: Age estimation, Schmeling method, Medial clavicular epiphysis, Computed tomography.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Determination by Skeleton* / methods
  • Clavicle* / diagnostic imaging
  • Epiphyses / diagnostic imaging
  • Female
  • Humans
  • Male
  • Osteogenesis
  • Pakistan
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods
  • Young Adult