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The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study

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Abstract

The clavicle plays an important role for forensic age estimation in living individuals, particularly with regard to the age of majority. The present prospective study aims to evaluate the age-dependent ossification process of the medial clavicular epiphysis in order to establish the clavicular sub-stages introduced in 2010 as well as the advantages and possibilities of thin-slice computed tomography (CT). For this purpose, 0.6 mm thin-slice CT scans of sternoclavicular joints of 572 bodies aged between 10 and 40 years were evaluated by means of two complementary classification systems: a five-stage system and a sub-staging system for the main stages 2 and 3. Assessment was possible in 493 cases. The results for stages 4 and 5 are in line with previous studies that found the ages of 21 years and 26 years, respectively, as minimum ages for these stages. Sub-stage 3c was first found at the age of 19 years in both sexes, thereby corroborating the value of this sub-stage as to statements about the age of majority. In comparison to other CT studies, stage 3a was first observed ~1 year earlier (16.4 years in males and 15.5 years in females). Stage 2c only occurred in 3 cases. In conclusion, the data corroborate the significance of diagnosing sub-stages as well as the value of thin-slice CT. For forensic practice, the concomitant and complementary use of both classification systems applied in this study can be recommended.

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Authors and Affiliations

  1. Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany

    Daniel Wittschieber, Ronald Schulz, Martin Küppers, Heidi Pfeiffer, Sven Schmidt & Andreas Schmeling

  2. Institute of Clinical Radiology, University Hospital Münster, Münster, Germany

    Volker Vieth

  3. Institute of Legal Medicine, University Hospital Essen, Essen, Germany

    Thomas Bajanowski

  4. Institute of Legal Medicine, University Hospital Frankfurt/Main, Frankfurt/Main, Germany

    Frank Ramsthaler

  5. Institute of Legal Medicine, University of the Saarland, Homburg/Saar, Germany

    Frank Ramsthaler

  6. Institute of Legal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Klaus Püschel

  7. Institute of Legal Medicine and Forensic Sciences, Charité, University Medicine Berlin, Berlin, Germany

    Sven Schmidt

Authors
  1. Daniel Wittschieber
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  2. Ronald Schulz
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  3. Volker Vieth
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  4. Martin Küppers
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  5. Thomas Bajanowski
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  6. Frank Ramsthaler
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  7. Klaus Püschel
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  8. Heidi Pfeiffer
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  9. Sven Schmidt
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  10. Andreas Schmeling
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Correspondence to Daniel Wittschieber.

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Wittschieber, D., Schulz, R., Vieth, V. et al. 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, 163–169 (2014). https://doi.org/10.1007/s12024-013-9511-x

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  • DOI: https://doi.org/10.1007/s12024-013-9511-x

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