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. 2016 May-Jun;22(3):241-6.
doi: 10.5152/dir.2016.15355.

CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults

Furkan Ufuk  1 , Kadir Agladioglu, Nevzat Karabulut
Affiliations

CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults

Furkan Ufuk et al. Diagn Interv Radiol. 2016 May-Jun.

Abstract

Purpose: We aimed to investigate the use of computed tomography (CT) staging of the medial clavicular epiphysis ossification in forensic bone age determination, and find a CT criterion to determine whether an individual is adult or not.

Methods: Chest CT and pulmonary CT angiography exams of 354 patients between 10 and 30 years of age (mean, 21.4 years) were retrospectively evaluated for epiphyseal ossification phase of the bilateral medial clavicles (708 clavicles) and compared with the sex and chronologic age of the individuals. The ossification phase of the medial clavicular epiphyses was classified from stage I to stage V using a modified staging system.

Results: Epiphyseal ossification center appeared from 11 to 21 years of age. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the ages of 18 and 19 years for male and female individuals, respectively. The probability of an individual being ≥18 years old was 70.8% in stage III A and 100% in stages III B, IV, and V in females and males.

Conclusion: CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage III B can be used as a criterion to make the prediction that an individual is older than 18 years.

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Figures

Figure. a. f
Figure. a. f
Axial CT images of the medial clavicle(s). A 10-year-old male (a) shows no ossification center in the medial clavicles (stage I). A 14-year-old female (b) shows ossified center with visible nonossified epiphyseal line in the medial clavicle (stage II). A 17-year-old female (c) shows ossification of ≤2/3 of epiphyseal cartilage (stage III A). A 20-year-old female (d) shows incomplete ossification of >2/3 of epiphyseal cartilage (stage III B). A 24-year-old male (e) shows complete ossification of epiphyseal cartilage with visible epiphyseal scar (arrows) (stage IV). A 26-year-old male (f) shows complete ossification of epiphyseal cartilage without visible epiphyseal scar (stage V).
See this image and copyright information in PMC

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