Magnetic Resonance Imaging of The Distal Radial Epiphysis Forensic Age Estimation in Living Individuals
Objective: Determining forensic age is very important in legal and civil rights cases, particularly in those involving children and young adults. Although methods for performing such estimates have been developed and their reliability has been demonstrated, radiation exposure has become controversial. In recent years, magnetic resonance imaging (MRI) has been used in an attempt to protect patients from radiation exposure. The aim of this study is to evaluate usefulness of staging via magnetic resonance imaging of distal radial epiphysis in age estimation.
Materials and Methods: In this study, 198 hand-wrists (patient age, 12–20 years) were retrospectively evaluated with MRI using the “distal radial epiphysis assessment method,” which was used previously by Dvorak to evaluate professional sportsmen.
Results: The ages at which bony fusion occurs have been identified. Females reach stage 2 at 13 years, stages 3 and 4 at 14 years, stage 5 at 15 years, and stage 6 at 16 years, whereas males reach stages 2 and 3 at 14 years, stage 4 at 15 years, and stages 5 and 6 at 16 years.
Conclusion: Although the non-ionizing Dvorak method of analyzing the distal radius epiphysis was successfully used for subjects aged 13–16 years, it failed to provide data about 17 and 18-year-olds. Thus, we need to develop a method for this age group and expand the applicable population.
2. Schmeling A, Grundmann C, Fuhrmann A, Kaatsch HJ, Knell B, Ramsthaler F, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G. Criteria for age estimation in living individuals. Int J Legal Med 2008;122(6):457–60. doi: 10.1007/s00414-008-0254-2
3. Cunha E, Baccino E, Martrille L, Ramsthaler F, Prieto J, Schuliar Y, Lynnerup N, Cattaneo C. The problem of aging human remains and living individuals: a review. For Sci Int 2009;193 (1-3):1-13. doi: 10.1016/j.forsciint.2009.09.008.
4. Schmeling A, Olze A, ReisingerW, Geserick G. Forensic age diagnostics of living people undergoing criminal proceedings. Forensic Sci Int 2004;144(2–3):243–245 doi: 10.1016/j.forsciint.2004.04.059
5. Janes L. Criminal liability of minors and severity of penalties: European trends and developments. Howard League for Penal Reform (England and Wales), 2008. http://www.europeanrights.eu/public/commenti/LauraJanes_en.pdf Accessed: 21 January 2014
6. Jones VF; Committee On Early Childhood, Adoption, And Dependent Care. Comprehensive health evaluation of the newly adopted child. Pediatrics 2012;129(1):e214-23. doi: 10.1542/peds.2011-2381.
7. UNHCR Asylum Trends 2014. Levels and Trends in Industrialized Countries. http://www.unhcr.org/551128679.html Erişim tarihi: 21.06.2016
8. UK Refugees Council. Statistics on Refugees and Asylum (2015). http://www.refugeecouncil.org.uk/assets/0003/5656/Asylum_Statistics_Aug_2015.pdf Erişim tarihi:21.06.2016
9. Schmeling A, Grundmann C, Fuhrmann A, Kaatsch HJ, Knell B, Ramsthaler F, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G. Criteria for age estimation in living individuals. Int J Legal Med 2008;122(6):457–60. doi: 10.1007/s00414-008-0254-2
10. Greulich W, Pyle SI. Radiographic Atlas of Skeletal Development of the Hand and Wrist, 2nd ed., Stanford University Press, Stanford, 1959.
11. Tanner JM, Whitehouse RH, Marshall WA, Healy MJR, Goldstein H . Assessment of Skeletal Maturity and Prediction of Adult Height (TW2 Method), Academic Press, London, 1975.
12. Schmidt S, Schiborr M, Pfeiffer H, Schmeling A, Schulz R. Age dependence of epiphyseal ossification of the distal radius in ultrasound diagnostics. Int. J. Legal Med. 2013;127:831–838. doi: 10.1007/s00414-013-0871-2
13. Schmidt S, Schiborr M, Pfeiffer H, Schmeling A, Schulz R. Sonographic examination of the apophysis of the iliac crest for forensic age estimation in living persons. Sci. Justice 2013;53:395–401. doi: 10.1016/j.scijus.2013.05.004
14. Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A. Sonographische Untersuchungen zum zeitlichen Verlauf der Ossifikation der distalen Fibulaepiphyse [Sonographic examination on the time frame of ossification of the distal fibula epiphysis]. Arch. Kriminol. 2013;31:156–165. PMID: 23878894
15. Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A. Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals. Forensic Sci. Med. Pathol. 2013;9:351–357. doi: 10.1007/s12024-013-9440-8.
16. Schmidt S, Mühler M, Schmeling A, Reisinger W, Schulz R. Magnetic resonance imaging of the clavicular ossification. Int. J. Legal Med. 2007;21:321–324 doi: 10.1007/s00414-007-0160-z
17. Tangmose S, Jensen KE, Villa C, Lynnerup N. Forensic age estimation from the clavicle using 1.0T MRI—preliminary results. For. Sci. Int. 2014;234:7-12 doi: 10.1016/j.forsciint.2013.10.027.
18. Hillewig E, Degroote J, Van der Paelt T, Visscher A, Vandemaele P, Lutin B, D'Hooghe L, Vandriessche V, Piette M, Verstraete K. Magnetic resonance imaging of the sternal extremity of the clavicle in forensic age estimation: towards more sound age estimates. Int. J. Legal Med. 2013;127:677-89 doi: 10.1007/s00414-012-0798-z
19. Vieth V, Schulz R, Brinkmeier P, Dvorak J, Schmeling A. Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle. For. Sci. Int. 2014;241:118-22. doi: 10.1016/j.forsciint.2014.05.008.
20. Saint-Martin P, Rérolle C, Dedouit F, Bouilleau L, Rousseau H, Rougé D, Telmon N. Age estimation by magnetic resonance imaging of the distal tibial epiphysis and the calcaneum. Int. J. Legal Med. 2013;127:1023-30 doi: 10.1007/s00414-013-0844-5
21. Saint-Martin P, Rérolle C, Dedouit F, Rousseau H, Rougé D, Telmon N. Evaluation of an automatic method for forensic age estimation by magnetic resonance imaging of the distal tibial epiphysis--a preliminary study focusing on the 18-year threshold. Int. J. Legal Med. 2014;128:675-83. doi: 10.1007/s00414-014-0987-z.
22. Ekizoglu O, Hocaoglu E, Can IO, Inci E, Aksoy S, Bilgili MG,. Magnetic resonance imaging of distal tibia and calcaneus for forensic age estimation in living individuals.. Int. J. Legal Med. 2015;129: 825-31. doi: 10.1007/s00414-015-1187-1
23. Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V. The use of magnetic resonance imaging to examine ossification of the proximal tibial epiphysis for forensic age estimation in living individuals. Forensic Sci. Med. Pathol. 2014;10:306-13. doi: 10.1007/s12024-014-9559-2.
24. Dedouit F, Auriol J, Rousseau H, Rougé D, Crubézy E, Telmon N. Age assessment by magnetic resonance imaging of the knee: a preliminary study. For. Sci. Int. 2012;217: e1–e7. doi: 10.1016/j.forsciint.2011.11.013
25. Wittschieber D, Vieth V, Timme M, Dvorak J, Schmeling A. Magnetic resonance imaging of the iliac crest: age estimation in under-20 soccer players. Forensic Sci. Med. Pathol. 2014;10:198-202. doi: 10.1007/s12024-014-9548-5
26. Dvorak J, George J, Junge A, Hodler J. Age determination by magnetic resonance imaging of the wrist in adolescent male football players. Br J Sports Med 2007;41(1):45–52 doi: 10.1136/bjsm.2006.031021
27. Dvorak J, George J, Junge A, Hodler J. Application of MRI of the wrist for age determination in international U-17 soccer competitions. Br J Sports Med 2007;41(8):497–500 doi: 10.1136/bjsm.2006.033431
28. George J, Nagendran J, Azmi K. Comparison study of growth plate fusion using MRI versus plain radiographs as used in age determination for exclusion of overaged football players. Br J Sports Med 2012;46(4):273–278 doi: 10.1136/bjsm.2010.074948
29. Terada Y, Kono S, Tamada D, Uchiumi T, Kose K, Miyagi R, Yamabe E, Yoshioka H Skeletal age assessment in children using an open compact MRI system. Magn Reson Med 2013;69(6):1697– 1702 doi: 10.1002/mrm.24439
30. Tomei E, Battisti S, Martino M, Nissman D, Semelka RC. Text-atlas of skeletal age determination: MRI of the hand and wrist in children. Wiley-Blackwell, Hoboken,2014.
31. Tomei E, Sartori A, Nissman D, Al Ansari N, Battisti S, Rubini A, Stagnitti A, Martino M, Marini M, Barbato E, Semelka RC. Value of MRI of the hand and the wrist in evaluation of bone age: preliminary results. J Magn Reson Imaging 2014;39(5):1198–1205 doi: 10.1002/jmri.24286
32. Serinelli S, Panebianco V, Martino M, Battisti S, Rodacki K, Marinelli E, Zaccagna F, Semelka RC, Tomei E. Accuracy of MRI skeletal age estimation for subjects 12-19. Potential use for subjects of unknown age. Int J Legal Med 2015;129(3):609-17. doi: 10.1007/s00414-015-1161-y.
33. Schmidt S, Vieth V, Timme M, Dvorak J, Schmeling A. Examination of ossification of the distal radial epiphysis using magnetic resonance imaging. New insights for age estimation in young footballers in FIFA tournaments. Sci Justice 2015;55(2):139-44. doi: 10.1016/j.scijus.2014.12.003.
34. Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V. Forensic age estimation in living individuals using 3.0T MRI of the distal femur. Int. J. Legal Med.2014;128:509-14. doi: 10.1007/s00414-014-0967-3
35. Dedouit F, Auriol J, Rousseau H, Rougé D, Crubézy E, Telmon N. Age assessment by magnetic resonance imaging of the knee: a preliminary study. For. Sci. Int. 2012;217:e1–e7. doi: 10.1016/j.forsciint.2011.11.013
36. Saint-Martin P, Rérolle C, Pucheux J, Dedouit F, Telmon N. Contribution of distal femur MRI to the determination of the 18-year limit in forensic age estimation. Int. J. Legal Med. 2014. E-pub ahead of print. doi: 10.1007/s00414-014-1020-2
37. Altman DG. Practical statistics for medical research. Chapman & Hall, New York, 1991.
38. Ramsthaler F, Proschek P, Betz W. How reliable are the risks estimates for X-ray examinations in forensic age estimations? A safety update. Int J Leg Med 2009;123:199-204 doi: 10.1007/s00414-009-0322-2
39. EURATOM (2010) Draft Euratom basic safety standards directive. http://ec.europa.eu/energy/nuclear/radiation_protection/doc/art31/2010_02_24_draft_euratom_basic_safety_standards_directive.pdf Erişim tarihi: 21.06.2016
40. Separated Children in Europe Programme—Thematic Group on Age Assessment (2011) Review of current laws, policies and practices relating to age assessment in sixteen European Countries. http://www.separated-children-europe-programme.org/publications/reports/Age_Assessment_report_review_of_current_policies_and_practice_in_Europe_2011_pdf.pdf Erişim tarihi: 21.06.2016
41. IAEA (2011) Radiation protection and safety of radiation sources: international basic safety standards—Interim Edition. Vienna. http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@safework/documents/publication/wcms_171036.pdf Erişim tarihi: 21.06.2016
42. Schmidt S, Koch B, Schulz R, Reisinger W, Schmeling A. Studies in use of the Greulich-Pyle skeletal age method to assess criminal liability. Legal Med (Tokyo) 2008;10(4):190–195 doi: 10.1016/j.legalmed.2008.01.003
43. Schmidt S, Nitz I, Schulz R, Schmeling A. Applicability of the skeletal age determination method of Tanner and Whitehouse for forensic age diagnostics. Int J Legal Med 2008;122(4):309–314 doi: 10.1007/s00414-008-0237-3
44. Büken B, Safak AA, Yazici B, Büken E, Mayda AS. Is the assessment of bone age by the Greulich-Pyle meted reliable at forensic age estimation for Turkish children? Forensic Sci Int. 2007;DOI:10.1016/j.forsciint.2007.02.023
45. A.I. Ortega, F. Haiter-Neto, G.M. Ambrosano, F.N. Bo´ scolo, S.M. Almeida, M.S. Casanova, Comparison of TW2 and TW3 skeletal age differences in a Brazilian population, J. Appl. Oral Sci. 2006;14(2):142–146 doi: 10.1590/S1678-77572006000200014
46. J. George, J. Nagendran, K. Azmi, Comparison study of growth plate fusion usingMRI versus plain radiographs as used in age determination for exclusion of overaged football players, Br. J. Sports Med. 2012;46:273–278.
47. Schmeling A, Reisinger W, Loreck D, Vendura K, Markus W, Geserick G. Effects of ethnicity on skeletal maturation:consequences for forensic age estimations. Int J Leg Med 2000;113: 253–258 doi: 10.1007/s004149900102
48. Schmeling A, Olze A, Reisinger W, Geserick G. Forensic age estimation and ethnicity. Leg Med 2005;7:134–137 doi: 10.1016/j.legalmed.2004.07.004
49. Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A. Influence of the examiner's qualification and sources of error during stage determination of the medial clavicular epiphysis by means of computed tomography. Int J Legal Med. 2014;128(1):183-91. doi: 10.1007/s00414-013-0932-6.
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Bulletin of Legal Medicine is an open access scientific journal. Open access means that all content is freely available without charge to the user or his/her institution on the principle that making research freely available to the public supports a greater global exchange of knowledge. The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access.
The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
The Bulletin of Legal Medicine requires the author as the rights holder to sign and submit the journal's agreement form prior to acceptance. The authors retain copyright of their work and grant the Association for its publication. This ensures both that The Journal has the right to publish the article and that the author has confirmed various things including that it is their original work and that it is based on valid research.
Authors who publish with this journal agree to the following terms:
*Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
*Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
*Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.