Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography

Int J Legal Med. 2004 Feb;118(1):5-8. doi: 10.1007/s00414-003-0404-5. Epub 2003 Oct 8.

Abstract

Radiological assessment of the degree of ossification of the medial clavicular epiphyseal cartilage plays a vital part in forensic age diagnosis of living adolescents and young adults. A total of 873 plain chest radiographs requested by the staff medical officer for members of staff aged 16-30 at the University Hospital Charité were evaluated retrospectively. Of these X-rays 699 permitted an assessment of ossification of at least 1 side of the clavicle. In addition to the customary stages (1: non-ossified epiphysis, 2: discernible ossification centre, 3: partial fusion, 4: total fusion) a stage 5 was also defined, characterised by the disappearance of the epiphyseal scar following total fusion. The earliest age at which stage 3 was detected in either gender was 16 years. Stage 4 was first observed in women at 20 years and in men at 21 years. In both genders, the earliest observation of stage 5 was at 26 years. It was concluded that plain chest radiographs can essentially be used to assess clavicular ossification. In practice, if overlap in posterior-anterior views impedes evaluation, a lateral view should also be taken to facilitate age estimation. In forensic practice the reference values of the present paper should be applied.

MeSH terms

  • Adolescent
  • Adult
  • Age Determination by Skeleton / methods*
  • Clavicle / diagnostic imaging*
  • Female
  • Forensic Medicine / methods
  • Growth Plate / diagnostic imaging*
  • Humans
  • Male
  • Osteogenesis*