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Published in: International Journal of Legal Medicine 6/2017

01-11-2017 | Original Article

Magnetic resonance imaging-based evaluation of ossification of the medial clavicular epiphysis in forensic age assessment

Authors: S. Schmidt, C. Ottow, H. Pfeiffer, W. Heindel, V. Vieth, A. Schmeling, R. Schulz

Published in: International Journal of Legal Medicine | Issue 6/2017

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Abstract

Evaluation of the degree of ossification of the medial clavicular epiphysis plays a crucial role in determining with an adequate degree of probability whether legally relevant age boundaries after the age of 17 have been crossed. In view of the need to avoid unnecessary radiation exposure, establishing non-X-ray methods for investigating the clavicle has long been a key objective in forensic age assessment research. Based on magnetic resonance imaging examinations in a large sample of healthy subjects, the current study for the first time presents statistical measures which allow inferences to be drawn for forensic age assessment in both sexes. We undertook a prospective study of a reference sample of 334 female and 335 male German volunteers aged from 12 to 24 using a 3-T MRI scanner. A 3D FFE (fast field echo) T1-weighted sequence with fat saturation was acquired. To stage ossification of the medial clavicular epiphysis, we used the clavicular ossification staging systems described by Schmeling et al. and Kellinghaus et al. Ossification stage IIIc offers a means in both sexes of demonstrating that the age of 18 has been attained prior to complete ossification of the epiphyseal plate. In both sexes, if a subject has reached ossification stage IV, it can be stated that he or she has attained the age of 21. Magnetic resonance imaging is a valid diagnostic procedure for determining the ossification stage of the medial clavicular epiphysis.
Literature
1.
go back to reference Ogden JA, Conlogue GJ, Bronson ML (1979) Radiology of postnatal skeletal development. III. The clavicle. Skelet Radiol 4:196–203CrossRef Ogden JA, Conlogue GJ, Bronson ML (1979) Radiology of postnatal skeletal development. III. The clavicle. Skelet Radiol 4:196–203CrossRef
2.
go back to reference Schmeling A, Schmidt S, Schulz R, Wittschieber D, Rudolf E (2014) Studienlage zum zeitlichen Verlauf der Schlüsselbeinossifikation. Rechtsmedizin 24:467–474CrossRef Schmeling A, Schmidt S, Schulz R, Wittschieber D, Rudolf E (2014) Studienlage zum zeitlichen Verlauf der Schlüsselbeinossifikation. Rechtsmedizin 24:467–474CrossRef
3.
go back to reference Jit I, Kulkarni M (1976) Times of appearance and fusion of epiphysis at the medial end of the clavicle. Indian J Med Res 64:773–782PubMed Jit I, Kulkarni M (1976) Times of appearance and fusion of epiphysis at the medial end of the clavicle. Indian J Med Res 64:773–782PubMed
4.
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 124:321–325CrossRefPubMed 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 124:321–325CrossRefPubMed
5.
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 Legal Med 124:149–154CrossRefPubMed 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 Legal Med 124:149–154CrossRefPubMed
6.
go back to reference Kreitner KF, Schweden F, Riepert T, Nafe B, Thelen M (1998) Bone age determination based on the study of the medial extremity of the clavicle. Eur Radiol 8:1116–1122CrossRefPubMed Kreitner KF, Schweden F, Riepert T, Nafe B, Thelen M (1998) Bone age determination based on the study of the medial extremity of the clavicle. Eur Radiol 8:1116–1122CrossRefPubMed
7.
go back to reference Schmeling A, Schulz R, Reisinger W, Mühler M, Wernecke KD, Geserick G (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118:5–8CrossRefPubMed Schmeling A, Schulz R, Reisinger W, Mühler M, Wernecke KD, Geserick G (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118:5–8CrossRefPubMed
8.
go back to reference Schulz R, Mühler M, Mutze S, Schmidt S, Reisinger W, Schmeling A (2005) Studies on the time frame for ossification of the medial epiphysis of the clavicle as revealed by CT scans. Int J Legal Med 119:142–145CrossRefPubMed Schulz R, Mühler M, Mutze S, Schmidt S, Reisinger W, Schmeling A (2005) Studies on the time frame for ossification of the medial epiphysis of the clavicle as revealed by CT scans. Int J Legal Med 119:142–145CrossRefPubMed
9.
go back to reference Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study. Forensic Sci Med Pathol 10:163–169CrossRefPubMed Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study. Forensic Sci Med Pathol 10:163–169CrossRefPubMed
10.
go back to reference Wittschieber D, Ottow C, Vieth V, Küppers M, Schulz R, Hassu J, Bajanowski T, Püschel K, Ramsthaler F, Pfeiffer H, Schmidt S, Schmeling A (2015) Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 129:187–193CrossRefPubMed Wittschieber D, Ottow C, Vieth V, Küppers M, Schulz R, Hassu J, Bajanowski T, Püschel K, Ramsthaler F, Pfeiffer H, Schmidt S, Schmeling A (2015) Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 129:187–193CrossRefPubMed
11.
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) Aktualisierte Empfehlungen der Arbeitsgemeinschaft für Forensische Altersdiagnostik für Altersschätzungen bei Lebenden im Strafverfahren. Rechtsmedizin 18:451–453CrossRef 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) Aktualisierte Empfehlungen der Arbeitsgemeinschaft für Forensische Altersdiagnostik für Altersschätzungen bei Lebenden im Strafverfahren. Rechtsmedizin 18:451–453CrossRef
12.
go back to reference Quirmbach F, Ramsthaler F, Verhoff MA (2009) Evaluation of the ossification of the medial clavicular epiphysis with a digital ultrasonic system to determine the age threshold of 21 years. Int J Legal Med 123:241–245CrossRefPubMed Quirmbach F, Ramsthaler F, Verhoff MA (2009) Evaluation of the ossification of the medial clavicular epiphysis with a digital ultrasonic system to determine the age threshold of 21 years. Int J Legal Med 123:241–245CrossRefPubMed
13.
go back to reference Schulz R, Zwiesigk P, Schiborr M, Schmidt S, Schmeling A (2008) Ultrasound studies on the time course of clavicular ossification. Int J Legal Med 122:163–167CrossRefPubMed Schulz R, Zwiesigk P, Schiborr M, Schmidt S, Schmeling A (2008) Ultrasound studies on the time course of clavicular ossification. Int J Legal Med 122:163–167CrossRefPubMed
14.
go back to reference Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A (2013) Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals. Forensic Sci Med Pathol 9:351–357CrossRefPubMed Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A (2013) Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals. Forensic Sci Med Pathol 9:351–357CrossRefPubMed
15.
go back to reference Schmidt S, Mühler M, Schmeling A, Reisinger W, Schulz R (2007) Magnetic resonance imaging of the clavicular ossification. Int J Legal Med 121:321–324CrossRefPubMed Schmidt S, Mühler M, Schmeling A, Reisinger W, Schulz R (2007) Magnetic resonance imaging of the clavicular ossification. Int J Legal Med 121:321–324CrossRefPubMed
16.
go back to reference Hillewig E, De Tobel J, Cuche O, Vandemaele P, Piette M, Verstraete K (2011) Magnetic resonance imaging of the medial extremity of the clavicle in forensic bone age determination: a new four-minute approach. Eur Radiol 21:757–767CrossRefPubMed Hillewig E, De Tobel J, Cuche O, Vandemaele P, Piette M, Verstraete K (2011) Magnetic resonance imaging of the medial extremity of the clavicle in forensic bone age determination: a new four-minute approach. Eur Radiol 21:757–767CrossRefPubMed
17.
go back to reference Hillewig E, Degroote J, van der Paelt T, Visscher A, Vandemaele P, Lutin B, D’Hooghe L, Vandriessche V, Piette M, Verstraete K (2013) Magnetic resonance imaging of the sternal extremity of the clavicle in forensic age estimation: towards more sound age estimates. Int J Legal Med 127:677–689CrossRefPubMed Hillewig E, Degroote J, van der Paelt T, Visscher A, Vandemaele P, Lutin B, D’Hooghe L, Vandriessche V, Piette M, Verstraete K (2013) Magnetic resonance imaging of the sternal extremity of the clavicle in forensic age estimation: towards more sound age estimates. Int J Legal Med 127:677–689CrossRefPubMed
18.
go back to reference Hollnberger J (2011) Validierung der Ossifikation der medialen Claviculaepiphyse mit der Magnetresonanztomografie. Dissertation, Jena Hollnberger J (2011) Validierung der Ossifikation der medialen Claviculaepiphyse mit der Magnetresonanztomografie. Dissertation, Jena
19.
go back to reference Schmidt S, Henke CA, Wittschieber D, Vieth V, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmeling A, Schulz R (2016) Optimising magnetic resonance imaging-based evaluation of the ossification of the medial clavicular epiphysis. A multi-centre study. Int J Legal Med 130:1615–1621CrossRefPubMed Schmidt S, Henke CA, Wittschieber D, Vieth V, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmeling A, Schulz R (2016) Optimising magnetic resonance imaging-based evaluation of the ossification of the medial clavicular epiphysis. A multi-centre study. Int J Legal Med 130:1615–1621CrossRefPubMed
20.
go back to reference Tangmose S, Jensen KE, Lynnerup N (2013) Comparative study on developmental stages of the clavicle by postmortem MRI and CT imaging. J Forensic Radiol Imaging 1:102–106CrossRef Tangmose S, Jensen KE, Lynnerup N (2013) Comparative study on developmental stages of the clavicle by postmortem MRI and CT imaging. J Forensic Radiol Imaging 1:102–106CrossRef
21.
go back to reference Tangmose S, Jensen KE, Villa C, Lynnerup N (2014) Forensic age estimation from the clavicle using 1.0T MRI—preliminary results. Forensic Sci Int 234:7–12CrossRefPubMed Tangmose S, Jensen KE, Villa C, Lynnerup N (2014) Forensic age estimation from the clavicle using 1.0T MRI—preliminary results. Forensic Sci Int 234:7–12CrossRefPubMed
22.
go back to reference Vieth V, Schulz R, Brinkmeier P, Dvorak J, Schmeling A (2014) Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle. Forensic Sci Int 241:118–122CrossRefPubMed Vieth V, Schulz R, Brinkmeier P, Dvorak J, Schmeling A (2014) Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle. Forensic Sci Int 241:118–122CrossRefPubMed
23.
go back to reference Wittschieber D, Vieth V, Timme M, Dvorak J, Schmeling A (2014) Magnetic resonance imaging of the iliac crest: age estimation in under-20 soccer players. Forensic Sci Med Pathol 10:198–202CrossRefPubMed Wittschieber D, Vieth V, Timme M, Dvorak J, Schmeling A (2014) Magnetic resonance imaging of the iliac crest: age estimation in under-20 soccer players. Forensic Sci Med Pathol 10:198–202CrossRefPubMed
24.
go back to reference Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V (2014) Forensic age estimation in living individuals using 3.0 T MRI of the distal femur. Int J Legal Med 128:509–514CrossRefPubMed Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V (2014) Forensic age estimation in living individuals using 3.0 T MRI of the distal femur. Int J Legal Med 128:509–514CrossRefPubMed
25.
go back to reference Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V (2014) 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 10:306–313CrossRefPubMed Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V (2014) 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 10:306–313CrossRefPubMed
26.
go back to reference Guo Y, Olze A, Ottow C, Schmidt S, Schulz R, Heindel W, Pfeiffer H, Vieth V, Schmeling A (2015) Dental age estimation in living individuals using 3.0 T MRI of lower third molars. Int J Legal Med 129:1265–1270CrossRefPubMed Guo Y, Olze A, Ottow C, Schmidt S, Schulz R, Heindel W, Pfeiffer H, Vieth V, Schmeling A (2015) Dental age estimation in living individuals using 3.0 T MRI of lower third molars. Int J Legal Med 129:1265–1270CrossRefPubMed
27.
go back to reference Schmidt S, Vieth V, Timme M, Dvorak J, Schmeling A (2015) 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 55:139–144CrossRefPubMed Schmidt S, Vieth V, Timme M, Dvorak J, Schmeling A (2015) 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 55:139–144CrossRefPubMed
28.
go back to reference Timme M, Ottow C, Schulz R, Pfeiffer H, Heindel W, Vieth V, Schmeling A, Schmidt S (2017) Magnetic resonance imaging of the distal radial epiphysis: a new criterion of maturity for determining whether the age of 18 has been completed? Int J Legal Med 131:579-584 Timme M, Ottow C, Schulz R, Pfeiffer H, Heindel W, Vieth V, Schmeling A, Schmidt S (2017) Magnetic resonance imaging of the distal radial epiphysis: a new criterion of maturity for determining whether the age of 18 has been completed? Int J Legal Med 131:579-584
29.
go back to reference Gelbrich B, Lessig R, Lehmann M, Dannhauer K-H, Gelbrich G (2010) Altersselektion in Referenzstichproben. Auswirkung auf die forensische Altersschätzung. Rechtsmedizin 20:459–463CrossRef Gelbrich B, Lessig R, Lehmann M, Dannhauer K-H, Gelbrich G (2010) Altersselektion in Referenzstichproben. Auswirkung auf die forensische Altersschätzung. Rechtsmedizin 20:459–463CrossRef
30.
go back to reference Link TM, Vieth V, Stehling C, Lotter A, Beer A, Newitt D, Majumdar S (2003) High-resolution MRI vs multislice spiral CT: which technique depicts the trabecular bone structure best? Eur Radiol 13:663–671PubMed Link TM, Vieth V, Stehling C, Lotter A, Beer A, Newitt D, Majumdar S (2003) High-resolution MRI vs multislice spiral CT: which technique depicts the trabecular bone structure best? Eur Radiol 13:663–671PubMed
31.
go back to reference Owings Webb PA, Myers Suchey J (1985) Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females. Am J Phys Anthropol 68:457–466CrossRef Owings Webb PA, Myers Suchey J (1985) Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females. Am J Phys Anthropol 68:457–466CrossRef
32.
go back to reference Wittschieber D, Schulz R, Pfeiffer H, Schmeling A, Schmidt S (2016) Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics. Int J Legal Med 131:217–224CrossRefPubMed Wittschieber D, Schulz R, Pfeiffer H, Schmeling A, Schmidt S (2016) Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics. Int J Legal Med 131:217–224CrossRefPubMed
33.
go back to reference Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) 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 128:183–191CrossRefPubMed Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) 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 128:183–191CrossRefPubMed
34.
go back to reference Tisè M, Mazzarini L, Fabrizzi G, Ferrante L, Giorgetti R, Tagliabracci A (2011) Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample. Int J Legal Med 125:411–416CrossRefPubMed Tisè M, Mazzarini L, Fabrizzi G, Ferrante L, Giorgetti R, Tagliabracci A (2011) Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample. Int J Legal Med 125:411–416CrossRefPubMed
Metadata
Title
Magnetic resonance imaging-based evaluation of ossification of the medial clavicular epiphysis in forensic age assessment
Authors
S. Schmidt
C. Ottow
H. Pfeiffer
W. Heindel
V. Vieth
A. Schmeling
R. Schulz
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Legal Medicine / Issue 6/2017
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-017-1676-5

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