International Journal of Legal Medicine

, Volume 133, Issue 5, pp 1517–1528 | Cite as

Anatomic shape variants of extremitas sternalis claviculae as collected from sternoclavicular thin-slice CT-studies of 2820 male borderline-adults

  • Ernst Rudolf
  • Josef Kramer
  • Sven Schmidt
  • Volker Vieth
  • Ingemar Winkler
  • Andreas Schmeling
Original Article


Within medical age assessment practice, the indicator “medial clavicular ossification” constitutes crucial evidence capable of excluding age minority “beyond reasonable doubt” concerning age-disputed individuals doubtfully claiming children’s rights during legal procedures. Yet, one of its characteristics affects the morphological variability including a fair amount of downright peculiar appearances. As a result, inexperienced examiners are tempted to classify actually not-assessable formations according to the two established developmental typologies of Schmeling et al. and Kellinghaus et al. being at the same time the most frequent systemic error of age-related clavicular taxation. Since a respective overview appears missing, the study extracts not-assessable shape variants of the medial collar bone from a large sample of 2820 male borderline-adults as seen from thin-slice, sternoclavicular computed tomography. The two already highlighted configurations “more than one, medial, secondary ossification centres” and “medial metaphyseal concavity” are found as the most commonly encountered features impeding reliable delineation of staging criteria. In accordance with previous literature, it is emphasized that “qualified” rating of extremitas sternalis claviculae within age assessment practice presupposes “knowledge about the diversity of [its] anatomic shape variants.”


Medical age assessment Medial clavicular ossification Not-assessable shape variants Computed tomography 



The authors would like to thank Herr A. Böhm from “Siemens Healthineers Austria” for suggesting 3D-“cinematic rendering” by means of syngo.via® software, which allows for viewing photorealistic, plastic renditions of ESC-appearances, and Mrs. Liu Ping for translating [104].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ernst Rudolf
    • 1
  • Josef Kramer
    • 2
  • Sven Schmidt
    • 3
  • Volker Vieth
    • 4
    • 5
  • Ingemar Winkler
    • 6
  • Andreas Schmeling
    • 3
  1. 1.Attnang-PuchheimAustria
  2. 2.Institute for CT and MRT DiagnosticsLinzAustria
  3. 3.Institute of Legal MedicineUniversity Hospital MünsterMünsterGermany
  4. 4.Department of Clinical RadiologyUniversity Hospital MünsterMünsterGermany
  5. 5.Clinic for RadiologyKlinikum IbbenbürenIbbenbürenGermany
  6. 6.Rax-Bergen 27JennersdorfAustria

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