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01-01-2017 | Review

Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics

Authors: Daniel Wittschieber, Ronald Schulz, Heidi Pfeiffer, Andreas Schmeling, Sven Schmidt

Published in: International Journal of Legal Medicine | Issue 1/2017

Abstract

In forensic age estimations of living individuals, computed tomography of the clavicle is widely used for determining the age of majority. To this end, the degree of ossification of the medial clavicular epiphysis can be determined by means of two classification systems complementing each other: a 5-stage system and an additional 6-stage system that further sub-classifies the stages 2 and 3. In recent years, practical experience and new data revealed that difficulties and even wrong stage determinations may occur especially when following the short descriptions of the fundamental 5-stage system only. Based on current literature, this article provides a systematic procedure for identifying the five main ossification stages by listing important preconditions and presenting an algorithm that is comprised of four specific questions. Each question is accompanied by comprehensive and detailed descriptions which specify the criteria used for differentiation. The information is subdivided into “single-slice view” and “multi-slice view.” In addition, illustrative case examples and schematic drawings facilitate application of the procedure in forensic practice. The pitfalls associated with the criteria of stage determination will be discussed in detail. Eventually, two general rules will be inferred to assign correct ossification stages of the medial clavicular epiphysis by means of computed tomography.

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Title: Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics
Authors: Daniel Wittschieber
Ronald Schulz
Heidi Pfeiffer
Andreas Schmeling
Sven Schmidt
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Legal Medicine / Issue 1/2017
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-016-1444-y

At a glance: The STEP trials

Springer Medicine

Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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