International Journal of Legal Medicine

, Volume 118, Issue 1, pp 5–8 | Cite as

Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography

  • Andreas SchmelingEmail author
  • Ronald Schulz
  • Walter Reisinger
  • Matthias Mühler
  • Klaus-Dieter Wernecke
  • Gunther Geserick
Original Article


Radiological assessment of the degree of ossification of the medial clavicular epiphyseal cartilage plays a vital part in forensic age diagnosis of living adolescents and young adults. A total of 873 plain chest radiographs requested by the staff medical officer for members of staff aged 16–30 at the University Hospital Charité were evaluated retrospectively. Of these X-rays 699 permitted an assessment of ossification of at least 1 side of the clavicle. In addition to the customary stages (1: non-ossified epiphysis, 2: discernible ossification centre, 3: partial fusion, 4: total fusion) a stage 5 was also defined, characterised by the disappearance of the epiphyseal scar following total fusion. The earliest age at which stage 3 was detected in either gender was 16 years. Stage 4 was first observed in women at 20 years and in men at 21 years. In both genders, the earliest observation of stage 5 was at 26 years. It was concluded that plain chest radiographs can essentially be used to assess clavicular ossification. In practice, if overlap in posterior-anterior views impedes evaluation, a lateral view should also be taken to facilitate age estimation. In forensic practice the reference values of the present paper should be applied.


Forensic age diagnosis Skeletal age Ossification Clavicle 


  1. Angenendt S (1999) Asylum and migration policies in the European Union. Union Verlag, BonnGoogle Scholar
  2. Black SM, Scheuer JL (1996) Age changes in the clavicle: from the early neonatal period to skeletal maturity. Int J Osteoarcheol 6:425–434CrossRefGoogle Scholar
  3. Dünkel F, Kalmthout A van, Schüler-Springorum H (1997) Entwicklungstendenzen und Reformstrategien im Jugendstrafrecht im europäischen Vergleich. Forum, MönchengladbachGoogle Scholar
  4. Flecker H (1933) Roentgenographic observations of the times of appearance of epiphyses and their fusion with the diaphyses. J Anat 67:118–164Google Scholar
  5. Galstaun G (1937) A study of ossification as observed in Indian subjects. Indian J Med Res 25:267–324Google Scholar
  6. Ji L, Terazawa K, Tsukamoto T, Haga K (1994) Estimation of age from epiphyseal union degrees of the sternal end of the clavicle. Hokkaido Igaku Zasshi 69:104–111PubMedGoogle Scholar
  7. Jit I, Kullkarni M (1976) Times of appearance and fusion of epiphysis at the medial end of the clavicle. Indian J Med Res 64:773–782PubMedGoogle Scholar
  8. Kaatsch H-J (2001) Juristische Aspekte der Altersschätzung. In: Oehmichen M, Geserick G (eds) Osteologische Identifikation und Altersschätzung. Schmidt-Römhild, Lübeck, pp 243–254Google Scholar
  9. Kahl B, Schwarze CW (1988) Aktualisierung der Dentitionstabelle von I Schour und M Massler von 1941. Fortschr Kieferorthop 49:432–443PubMedGoogle Scholar
  10. Kreitner K-F, Schweden F, Schild HH, Riepert T, Nafe B (1997) Die computertomographisch bestimmte Ausreifung der medialen Klavikulaepiphyse—eine additive Methode zur Altersbestimmung im Adoleszentenalter und in der dritten Lebensdekade? Fortschr Röntgenstr 166:481–486Google Scholar
  11. Kreitner K-F, Schweden FJ, Riepert T, Nafe B, Thelen M (1998) Bone age determination based on the study of the medial extremity of the clavicle. Eur Radiol 8:1116–1122CrossRefPubMedGoogle Scholar
  12. MacLaughlin SM (1990) Epiphyseal fusion at the sternal end of the clavicle in a modern Portugese skeletal sample. Antropol Port 8:59–68Google Scholar
  13. McKern TW, Stewart TD (1957) Skeletal age changes in young American males. Analysed from the standpoint of age identification. In: Technical report EP 45. Quartermaster Research and Development Center, Environmental Protection Research Division. Natick, Massachusetts, pp 89–97Google Scholar
  14. Ohtani S (2002) Technical notes for age estimation using the femur: influence of various analytical conditions on D-aspartic acid contents. Int J Legal Med 116:361–364PubMedGoogle Scholar
  15. Ohtani S, Ito R, Yamamoto T (2003) Differences in the D/L aspartic acid ratios in dentin among different types of teeth from the same individual and estimated age. Int J Legal Med 117:149–152PubMedGoogle Scholar
  16. Olze A, Schmeling A, Rieger K, Kalb G, Geserick G (2003) Untersuchungen zum zeitlichen Verlauf der Weisheitszahnmineralisation bei einer deutschen Population. Rechtsmedizin 13:5–10Google Scholar
  17. Owings Webb PA, Myers Suchey J (1985) Epiphyseal union of the anterior iliac crest and medial clavicle in an modern multiracial sample of American males and females. Am J Phys Anthropol 68:457–466PubMedGoogle Scholar
  18. Ritz S, Schütz HW, Peper C (1993) Postmortem estimation of age at death based on aspartic acid racemization in dentin: its applicability for dentin. Int J Legal Med 105:89–193Google Scholar
  19. 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 Legal Med 113:253–258PubMedGoogle Scholar
  20. Schmeling A, Kaatsch H-J, Marré B, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G (2001a) Empfehlungen für die Altersdiagnostik bei Lebenden im Strafverfahren. Rechtsmedizin 11:1–3CrossRefGoogle Scholar
  21. Schmeling A, Olze A, Reisinger W, Geserick G (2001b) Age estimation of living people undergoing criminal proceedings. Lancet 358:89–90Google Scholar
  22. Todd TW, D’Errico J (1928) The clavicular epiphyses. Am J Anat 41:25–50Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Andreas Schmeling
    • 1
    Email author
  • Ronald Schulz
    • 1
  • Walter Reisinger
    • 2
  • Matthias Mühler
    • 2
  • Klaus-Dieter Wernecke
    • 3
  • Gunther Geserick
    • 1
  1. 1.Institut für RechtsmedizinUniversitätsklinikum Charité der Humboldt-Universität zu BerlinBerlinGermany
  2. 2.Institut für RadiologieUniversitätsklinikum Charité der Humboldt-Universität zu BerlinBerlinGermany
  3. 3.Institut für Medizinische BiometrieUniversitätsklinikum Charité der Humboldt-Universität zu Berlin BerlinGermany

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