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Published in: International Journal of Legal Medicine 3/2011

01-05-2011 | Original Article

Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample

Authors: Marco Tisè, Laura Mazzarini, Giancarlo Fabrizzi, Luigi Ferrante, Raffaele Giorgetti, Adriano Tagliabracci

Published in: International Journal of Legal Medicine | Issue 3/2011

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Abstract

Background

The main importance in age estimation lies in the assessment of criminal liability and protection of unaccompanied minor immigrants, when their age is unknown. Under Italian law, persons are not criminally responsible before they reach the age of 14. The age of 18 is important when deciding whether juvenile or adult law must be applied. In the case of unaccompanied minors, it is important to assess age in order to establish special protective measures, and correct age estimation may prevent a person over 18 from benefiting from measures reserved for minors.

Objective

Since the Greulich and Pyle method is one of the most frequently used in age estimation, the aim of this study was to assess the reproducibility and accuracy of the method on a large Italian sample of teenagers, to ascertain the applicability of the Atlas at the critical age thresholds of 14 and 18 years.

Materials and methods

This retrospective study examined posteroanterior X-ray projections of hand and wrist from 484 Italian–Caucasian young people (125 females, 359 males) between 11 and 19 years old. All radiographic images were taken from trauma patients hospitalized in the Azienda Ospedaliero Universitaria Ospedali Riuniti of Ancona (Italy) between 2006 and 2007. Two physicians analyzed all radiographic images separately. The blind method was used.

Results

In the case of an estimated age of 14 years old, the true age ranged from 12.2 to 15.9 years (median, 14.3 years, interquartile range, 1.0 years) for males, and 12.6 to 15.7 years (median, 14.2 years, interquartile range, 1.7 years) for females. In the case of an estimated age of 18 years, the true age ranged from 15.6 to 19.7 years (median, 17.7 years, interquartile range, 1.4 years) for males, and from 16.2 to 20.0 years (median, 18.7 years, interquartile range, 1.8 years) for females.

Conclusion

Our study shows that although the GPM is a reproducible and repeatable method, there is a wide margin of error in the estimation of chronological age, mainly in the critical estimated ages of 14 and 18 years old in both males and females.
Literature
1.
go back to reference 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 (2008) Criteria for age estimation in living individuals. Int J Leg Med 122:457–460CrossRef 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 (2008) Criteria for age estimation in living individuals. Int J Leg Med 122:457–460CrossRef
2.
go back to reference Greulic WW, Pyle SI (1959) Radiographic Atlas of Skeletal Development of the Hand and Wrist, Sdth edn. Stanford University Press, Stanford, California Greulic WW, Pyle SI (1959) Radiographic Atlas of Skeletal Development of the Hand and Wrist, Sdth edn. Stanford University Press, Stanford, California
3.
go back to reference A Papoulis (1991) Probability, Random Variables, and Stochastic Processes, 3rd ed. McGraw-Hill. ISBN 0-07-100870-5. pp. 113–114 A Papoulis (1991) Probability, Random Variables, and Stochastic Processes, 3rd ed. McGraw-Hill. ISBN 0-07-100870-5. pp. 113–114
4.
go back to reference Passone C, Pastorin L, Rota A, Fabio Mt, Benso L (1981) Skeletal maturation of the school population of Turin. Comparison between of TW2 and Greulich-Pyle methods. III. 7 and 9-year-old males. Minerva Pediatr 33(9):436–437, 15PubMed Passone C, Pastorin L, Rota A, Fabio Mt, Benso L (1981) Skeletal maturation of the school population of Turin. Comparison between of TW2 and Greulich-Pyle methods. III. 7 and 9-year-old males. Minerva Pediatr 33(9):436–437, 15PubMed
5.
go back to reference Vignolo M, Milani S, Dibattista E, Naselli A, Mostert M, Aicardi G (1990) Modified Greulich-Pyle, Tanner-Whitehouse, and Roche-Wainer-Thissen (knee) methods for skeletal age assessment in a group of Italian children and adolescents. Eur J Pediatr 149(5):314–317PubMedCrossRef Vignolo M, Milani S, Dibattista E, Naselli A, Mostert M, Aicardi G (1990) Modified Greulich-Pyle, Tanner-Whitehouse, and Roche-Wainer-Thissen (knee) methods for skeletal age assessment in a group of Italian children and adolescents. Eur J Pediatr 149(5):314–317PubMedCrossRef
6.
go back to reference Tanner JM, Whitehouse RH, Cameron N (1990) Valutazione della maturazione scheletrica e predizione dell' altezza adulta (Metodo TW2). Prima edizione italiana, Martinucci Pubblicazioni Mediche, Napoli Tanner JM, Whitehouse RH, Cameron N (1990) Valutazione della maturazione scheletrica e predizione dell' altezza adulta (Metodo TW2). Prima edizione italiana, Martinucci Pubblicazioni Mediche, Napoli
7.
go back to reference Nicoletti I (1991) Crescita e maturazione scheletrica. Età ossea e predizione della statura adulta. Edizioni Centro Studi Auxologici, Firenze Nicoletti I (1991) Crescita e maturazione scheletrica. Età ossea e predizione della statura adulta. Edizioni Centro Studi Auxologici, Firenze
8.
go back to reference Roche AF, Roberts J, HamillP V (1976) Skeletal maturity of youths 12-17 years, United States. Vital Health Stat 11 160:1–90PubMed Roche AF, Roberts J, HamillP V (1976) Skeletal maturity of youths 12-17 years, United States. Vital Health Stat 11 160:1–90PubMed
9.
go back to reference Rt L, Dt E, Morrison K, Eggleston D, Dn F, Ml G, Ke G (1993) Applicability of the Greulich and Pyle skeletal age standards to black and white children of today. Am J Dis Child 147(12):1329–1333 Rt L, Dt E, Morrison K, Eggleston D, Dn F, Ml G, Ke G (1993) Applicability of the Greulich and Pyle skeletal age standards to black and white children of today. Am J Dis Child 147(12):1329–1333
10.
go back to reference Fk O, Ivanovic M, Ds A, Tw B (1996) Bone age in children of diverse ethnicity. AJR Am J Roentgenol 167(6):1395–1398 Fk O, Ivanovic M, Ds A, Tw B (1996) Bone age in children of diverse ethnicity. AJR Am J Roentgenol 167(6):1395–1398
11.
go back to reference Mora S, Ines Boechat M, Pietka E, Huang HK, Gilsanz V (2001) Skeletal age determinations in children of European and African descent: applicability of the Greulich and Pyle standards. Pediatr Res 50:624–628PubMedCrossRef Mora S, Ines Boechat M, Pietka E, Huang HK, Gilsanz V (2001) Skeletal age determinations in children of European and African descent: applicability of the Greulich and Pyle standards. Pediatr Res 50:624–628PubMedCrossRef
12.
go back to reference Rikhasor Rm, Qureshi Am, Rathi Sl, Channa Na (1999) Skeletal maturity in Pakistani children. J Anat 195(Pt 2):305–308PubMedCrossRef Rikhasor Rm, Qureshi Am, Rathi Sl, Channa Na (1999) Skeletal maturity in Pakistani children. J Anat 195(Pt 2):305–308PubMedCrossRef
13.
go back to reference Koc A, Karaoglanoglu M, Erdogan M, Kosecik M, Cesur Y (2001) Assessment of bone ages: is the Greulich-Pyle method sufficient for Turkish boys? Pediatr Int 43(6):662–665PubMedCrossRef Koc A, Karaoglanoglu M, Erdogan M, Kosecik M, Cesur Y (2001) Assessment of bone ages: is the Greulich-Pyle method sufficient for Turkish boys? Pediatr Int 43(6):662–665PubMedCrossRef
14.
go back to reference Chiang K-H, Chou Andy Shau-Bin, Yen P-S (2005) The reliability of using Greulich-Pyle method to determine children's bone age in Taiwan. Tzu Chi Med J 17:417–420 Chiang K-H, Chou Andy Shau-Bin, Yen P-S (2005) The reliability of using Greulich-Pyle method to determine children's bone age in Taiwan. Tzu Chi Med J 17:417–420
15.
go back to reference Lewis CP, Lavy CB, Harrison WJ (2002) Delay in skeletal maturity in Malawian children. J Bone Joint Surg Br 84(5):732–734PubMedCrossRef Lewis CP, Lavy CB, Harrison WJ (2002) Delay in skeletal maturity in Malawian children. J Bone Joint Surg Br 84(5):732–734PubMedCrossRef
16.
go back to reference Cole TJ, Cole AJ (1992) Bone age, social deprivation, and single parent families. Arch Dis Child 67(10):1281–1285PubMedCrossRef Cole TJ, Cole AJ (1992) Bone age, social deprivation, and single parent families. Arch Dis Child 67(10):1281–1285PubMedCrossRef
17.
go back to reference Schmeling A, Schulz R, Danner B, Rösing FW (2006) The impact of economic progress and modernization in medicine on the ossification of hand and wrist. Int J Leg Med 120(2):121–126CrossRef Schmeling A, Schulz R, Danner B, Rösing FW (2006) The impact of economic progress and modernization in medicine on the ossification of hand and wrist. Int J Leg Med 120(2):121–126CrossRef
18.
go back to reference Schmeling A, Reisinger W, Loreck D, Vendura K, Markus W, Geserick G (2000) Effects of ethnicity on skeletal maturation: consequences for forensic age estimations. Int J Leg Med 113(5):253–258CrossRef Schmeling A, Reisinger W, Loreck D, Vendura K, Markus W, Geserick G (2000) Effects of ethnicity on skeletal maturation: consequences for forensic age estimations. Int J Leg Med 113(5):253–258CrossRef
19.
go back to reference Kimura K (1977) Skeletal maturity of the hand and wrist in Japanese children in Sapporo by the TW2 method. Ann Hum Biol 4(5):449–453PubMedCrossRef Kimura K (1977) Skeletal maturity of the hand and wrist in Japanese children in Sapporo by the TW2 method. Ann Hum Biol 4(5):449–453PubMedCrossRef
20.
go back to reference Kimura K (1977) Skeletal maturity of the hand and wrist in Japanese children by the TW2 method. Ann Hum Biol 4(4):353–356PubMedCrossRef Kimura K (1977) Skeletal maturity of the hand and wrist in Japanese children by the TW2 method. Ann Hum Biol 4(4):353–356PubMedCrossRef
21.
go back to reference Greulich WW (1957) A comparison of the physical growth and development of American-born and native Japanese children. Am J Phys Anthropol 15(4):489–515PubMedCrossRef Greulich WW (1957) A comparison of the physical growth and development of American-born and native Japanese children. Am J Phys Anthropol 15(4):489–515PubMedCrossRef
22.
go back to reference Ferrante L, Cameriere R (2009) Statistical methods to assess the reliability of measurements in the procedures for forensic age estimation. Int J Leg Med 123(4):277–283CrossRef Ferrante L, Cameriere R (2009) Statistical methods to assess the reliability of measurements in the procedures for forensic age estimation. Int J Leg Med 123(4):277–283CrossRef
23.
go back to reference Garamendi PM, Landa MI, Ballesteros J, Solano MA (2005) Reliability of the methods applied to assess age minority in living subjects around 18 years old. A survey on a Moroccan origin population. Forensic Sci Int 154(1):3–12PubMedCrossRef Garamendi PM, Landa MI, Ballesteros J, Solano MA (2005) Reliability of the methods applied to assess age minority in living subjects around 18 years old. A survey on a Moroccan origin population. Forensic Sci Int 154(1):3–12PubMedCrossRef
24.
go back to reference Büken B, Safak AA, Yazici B, Büken E, Mayda AS (2007) Is the assessment of bone age by the Greulich-Pyle method reliable at forensic age estimation for Turkish children? Forensic Sci Int 173(2-3):146–153PubMedCrossRef Büken B, Safak AA, Yazici B, Büken E, Mayda AS (2007) Is the assessment of bone age by the Greulich-Pyle method reliable at forensic age estimation for Turkish children? Forensic Sci Int 173(2-3):146–153PubMedCrossRef
25.
go back to reference Berst MJ, Dolan L, Bogdanowicz MM, Stevens MA, Chow S, Brandser EA (2001) Effect of Knowledge of Chronologic Age on the Variability of Pediatric Bone Age Determined Using the Greulich and Pyle Standards. AJR 176:507–510PubMed Berst MJ, Dolan L, Bogdanowicz MM, Stevens MA, Chow S, Brandser EA (2001) Effect of Knowledge of Chronologic Age on the Variability of Pediatric Bone Age Determined Using the Greulich and Pyle Standards. AJR 176:507–510PubMed
26.
go back to reference Van Rijn RR, Lequin MH, Robben SG, Hop WC, Van Kuijk C (2001) Is the Greulich and Pyle atlas still valid for Dutch Caucasian children today? Pediatr Radiol 31(10):748–752PubMedCrossRef Van Rijn RR, Lequin MH, Robben SG, Hop WC, Van Kuijk C (2001) Is the Greulich and Pyle atlas still valid for Dutch Caucasian children today? Pediatr Radiol 31(10):748–752PubMedCrossRef
27.
go back to reference Lynnerup N, Belard E, Buch-Olsen K, Sejrsen B, Damgaard-Pedersen K (2008) Intra- and interobserver error of the Greulich-Pyle method as used on a Danish forensic sample. Forensic Sci Int 179(2–3):242–246PubMed Lynnerup N, Belard E, Buch-Olsen K, Sejrsen B, Damgaard-Pedersen K (2008) Intra- and interobserver error of the Greulich-Pyle method as used on a Danish forensic sample. Forensic Sci Int 179(2–3):242–246PubMed
28.
go back to reference Cameriere R, Ferrante L (2008) Age estimation in children by measurement of carpals and epiphyses of radius and ulna and open apices in teeth: a pilot study. Forensic Sci Int 174(1):60–63PubMedCrossRef Cameriere R, Ferrante L (2008) Age estimation in children by measurement of carpals and epiphyses of radius and ulna and open apices in teeth: a pilot study. Forensic Sci Int 174(1):60–63PubMedCrossRef
29.
go back to reference Kellinghaus M, Schulz R, Vieth V, Schmidt S, Schmeling A (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Leg Med 124(2):149–154CrossRef Kellinghaus M, Schulz R, Vieth V, Schmidt S, Schmeling A (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Leg Med 124(2):149–154CrossRef
30.
go back to reference Kellinghaus M, Schulz R, Vieth V, Schmidt S, Pfeiffer H, Schmeling A (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124(4):321–325PubMedCrossRef Kellinghaus M, Schulz R, Vieth V, Schmidt S, Pfeiffer H, Schmeling A (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124(4):321–325PubMedCrossRef
31.
go back to reference Olze A, Solheim T, Schulz R, Kupfer M, Pfeiffer H, Schmeling A (2010) Assessment of the radiographic visibility of the periodontal ligament in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(5):445–448PubMedCrossRef Olze A, Solheim T, Schulz R, Kupfer M, Pfeiffer H, Schmeling A (2010) Assessment of the radiographic visibility of the periodontal ligament in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(5):445–448PubMedCrossRef
32.
go back to reference Olze A, Solheim T, Schulz R, Kupfer M, Schmeling A (2010) Evaluation of the radiographic visibility of the root pulp in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(3):183–186PubMedCrossRef Olze A, Solheim T, Schulz R, Kupfer M, Schmeling A (2010) Evaluation of the radiographic visibility of the root pulp in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(3):183–186PubMedCrossRef
Metadata
Title
Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample
Authors
Marco Tisè
Laura Mazzarini
Giancarlo Fabrizzi
Luigi Ferrante
Raffaele Giorgetti
Adriano Tagliabracci
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
International Journal of Legal Medicine / Issue 3/2011
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-010-0541-6

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