Advertisement

International Journal of Legal Medicine

, Volume 127, Issue 3, pp 691–698 | Cite as

Skeletal age determination of the hand: a comparison of methods

  • S. SchmidtEmail author
  • I. Nitz
  • S. Ribbecke
  • R. Schulz
  • H. Pfeiffer
  • A. Schmeling
Original Article

Abstract

Until final completion of maturation processes at the age of approximately 18 years, determination of the skeletal age of the hand plays a central role in forensic age diagnostics in living persons in criminal proceedings. In this process, assessment of hand radiographs relies primarily on the stage of development of the epiphyseal nuclei, the increase in size of the individual bones and of the hand skeleton as a whole, changes in the shape of the various skeletal elements and ossification of the epiphyseal plates. To achieve this, there are a variety of methodological approaches based on two different fundamental principles. The methods proposed by Greulich and Pyle, Thiemann et al. and Gilsanz and Ratib rank among the so-called atlas techniques, whilst the methods proposed by Tanner et al. and Roche et al. are classified as so-called bone-specific techniques. In order to be applicable in the field of criminal procedure, the methods of estimating the skeletal age of the hand developed with clinical aspects in mind must satisfy the demands of a high degree of estimate accuracy and good reproducibility of the estimated results. In the course of the present study, a study population of 92 persons was used to compare the above-mentioned atlas and bone-specific techniques for determining hand skeleton age in view of these qualitative criteria. Estimate accuracy was studied using Pearson’s correlation coefficients, and weighted kappa coefficients were determined for studying the intra-and interobserver agreement of an estimate result. In the inter-method comparison, a basically good agreement was shown between the skeletal ages and the chronological age of the test persons on the one hand and the skeletal age diagnoses of one or of two examiners on the other. No general advantage of the methodological approach of the bone-specific technique was discernible in the course of comparison; in the female gender, particularly, the RUS2 and RUS3 score of the method of Tanner et al. proved unfavourable. For age estimation practice in criminal proceedings, the atlas methods of Greulich and Pyle and Thiemann et al. are particularly recommendable.

Keywords

Forensic age estimation Bone age Hand skeleton Comparison of methods Estimate accuracy Reproducibility 

Notes

Acknowledgments

The present study was supported by a grant from the German Research Foundation (SCHM 1609/5-1). The authors would like to thank Dr Karl Minas MD for his kind loan of the evaluated hand radiographs.

References

  1. 1.
    Andersen E (1971) Comparison of Tanner-Whitehouse and Greulich-Pyle methods in a large scale Danish survey. Am J Phys Anthropol 35:373–376PubMedCrossRefGoogle Scholar
  2. 2.
    Backhaus K, Erichson B, Plinke W, Weiber R (2006) Multivariate Analysemethoden–Eine anwendungsorientierte Einführung. Springer, BerlinGoogle Scholar
  3. 3.
    Baumann U, Schulz R, Heinecke A, Schmeling A, Schmidt S (2008) Reference study on the time frame for ossification of the distal radius and ulnar epiphysis on the hand radiograph. Forensic Sci Int 191:15–18CrossRefGoogle Scholar
  4. 4.
    Beunen G, Lefevre J, Ostyn M, Renson R, Simons J, van Gernen D (1990) Skeletal maturity in Belgian youths assessed by the Tanner-Whitehouse method (TW2). Ann Hum Biol 17:355–376PubMedCrossRefGoogle Scholar
  5. 5.
    Cameriere R, De Luca S, De Angelis D, Merelli V, Giuliodori A, Cingolani M, Cattaneo C, Ferrante L (2012) Reliability of Schmeling’s stages of ossification of medial clavicular epiphyses and its validity to assess 18 years of age in living subjects. Int J Legal Med 126:923–932PubMedCrossRefGoogle Scholar
  6. 6.
    Chumlea C (2011) Persönliche MitteilungGoogle Scholar
  7. 7.
    Cole AJL, Webb L, Cole TJ (1988) Bone age estimation: a comparison of methods. Br J Radiol 61:683–686PubMedCrossRefGoogle Scholar
  8. 8.
    Cox LA (1996) Tanner-Whitehouse method of assessing skeletal maturity: problems and common errors. Horm Res 45(Suppl 2):53–55PubMedCrossRefGoogle Scholar
  9. 9.
    Fendel H (1976) Die Methodik der radiologischen Skeletalterbestimmung. Radiologe 16:370–380PubMedGoogle Scholar
  10. 10.
    Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer, BerlinGoogle Scholar
  11. 11.
    Graham CB (1972) Assessment of bone maturation—methods and pitfalls. Radiol Clin N Amer 10:185–202PubMedGoogle Scholar
  12. 12.
    Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, StanfordGoogle Scholar
  13. 13.
    Haavikko K, Kilpinen E (1973) Skeletal development of Finnish children in the light of hand-wrist roentgenograms. Proc Finn Dent Soc 69:182–190PubMedGoogle Scholar
  14. 14.
    Hernández M, Sánchez E, Sobradillo B, Rincón JM (1991) Maduracion osea y prediction de la talla. Diaz de Santos, MadridGoogle Scholar
  15. 15.
    Kemperdick H (1986) Die Skelettalterbestimmung beim Kind. Radiologe 26:216–221PubMedGoogle Scholar
  16. 16.
    King DG, Steventon DM, O’Sullivan MP, Cook AM, Hornsby VP, Jefferson IG (1994) Reproducibility of bone ages when performed by radiology registrars: an audit of Tanner and Whitehouse II versus Greulich and Pyle methods. Br J Radiol 67:848–851PubMedCrossRefGoogle Scholar
  17. 17.
    Kopczynska-Sikorska J (1969) Atlas radiologiczny rozwoju koscca dloni i nadgastka. PZWL, WarszawaGoogle Scholar
  18. 18.
    van Lenthe FJ, Kemper HC, van Mechelen W (1998) Skeletal maturation in adolescence: a comparison between the Tanner-Whitehouse II and the Fels method. Eur J Pediatr 157:257–261Google Scholar
  19. 19.
    Olze A, Hertel J, Schulz R, Wierer T, Schmeling A (2012) Radiographic evaluation of Gustafson’s criteria for the purpose of forensic age diagnostics. Int J Legal Med 126:615–621PubMedCrossRefGoogle Scholar
  20. 20.
    Olze A, van Niekerk P, Schulz R, Ribbecke S, Schmeling A (2012) The influence of impaction on the rate of third molar mineralisation in male black Africans. Int J Legal Med 126:869–874PubMedCrossRefGoogle Scholar
  21. 21.
    Poland J (1898) Skiagraphic atlas showing the development of the bones of the wrist and hand, for the use of students and others. Smith, Elder, & Co, LondonGoogle Scholar
  22. 22.
    Roche AF, Chumlea WC, Thissen D (1988) Assessing the skeletal maturity of the hand-wrist: Fels method. C.C. Thomas, SpringfieldGoogle Scholar
  23. 23.
    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) Criteria for age estimation in living individuals. Int J Legal Med 122:457–460PubMedCrossRefGoogle Scholar
  24. 24.
    Schmid F, Moll H (1960) Atlas der normalen und pathologischen Handskelettentwicklung. Springer, BerlinCrossRefGoogle Scholar
  25. 25.
    Schmidt S, Koch B, Mühler M, Reisinger W, Schmeling A (2007) Optimizing the Thiemann-Nitz method for skeletal age determination for forensic age diagnostics in live subjects. Scand J Forensic Sci 13:5–7Google Scholar
  26. 26.
    Schmidt S, Koch B, Schulz R, Reisinger W, Schmeling A (2007) Comparative analysis of the applicability of the skeletal age determination methods of Greulich-Pyle and Thiemann-Nitz for forensic age estimation in living subjects. Int J Legal Med 121:293–296PubMedCrossRefGoogle Scholar
  27. 27.
    Schmidt S, Baumann U, Schulz R, Reisinger W, Schmeling A (2008) Study of age dependence of epiphyseal ossification of the hand skeleton. Int J Legal Med 122:51–54PubMedCrossRefGoogle Scholar
  28. 28.
    Schmidt S, Koch B, Schulz R, Reisinger W, Schmeling A (2008) Studies in use of the Greulich-Pyle skeletal age method to assess criminal liability. Leg Med (Tokyo) 10:190–195CrossRefGoogle Scholar
  29. 29.
    Schmidt S, Nitz I, Schulz R, Schmeling A (2008) Applicability of the skeletal age determination method of Tanner and Whitehouse for forensic age diagnostics. Int J Legal Med 122:309–314PubMedCrossRefGoogle Scholar
  30. 30.
    Schmidt S, Nitz I, Schulz R, Tsokos M, Schmeling A (2009) The digital atlas of skeletal maturity by Gilsanz and Ratib: a suitable alternative for age estimation of living individuals in criminal proceedings? Int J Legal Med 123:489–494PubMedCrossRefGoogle Scholar
  31. 31.
    Schmidt S, Fracasso T, Pfeiffer H, Schmeling A (2010) Skelettaltersbestimmung der Hand. Rechtsmedizin 20:475–482CrossRefGoogle Scholar
  32. 32.
    Schmidt S, Schmeling A, Zwiesigk P, Pfeiffer H, Schulz R (2011) Sonographic evaluation of apophyseal ossification of the iliac crest in forensic age diagnostics in living individuals. Int J Legal Med 125:271–276PubMedCrossRefGoogle Scholar
  33. 33.
    Siegert F (1935) Atlas der normalen Ossifikation der menschlichen Hand. Georg Thieme, LeipzigGoogle Scholar
  34. 34.
    Tanner JM, Whitehouse RH, Marshall WA, Healy MJR, Goldstein H (1983) Assessment of skeletal maturity and prediction of adult height (TW2 method), 2nd edn. Academic, LondonGoogle Scholar
  35. 35.
    Tanner JM, Oshman D, Bahhage F, Healy M (1997) Tanner-Whithouse bone age reference values for North American children. J Pediatr 131:34–40PubMedCrossRefGoogle Scholar
  36. 36.
    Tanner JM, Healy MJR, Goldstein H, Cameron N (2001) Assessment of skeletal maturity and prediction of adult height (TW3 method). W.B. Saunders, LondonGoogle Scholar
  37. 37.
    Thevissen PW, Galiti D, Willems G (2012) Human dental age estimation combining third molar(s) development and tooth morphological age predictors. Int J Legal Med 126:883–887PubMedCrossRefGoogle Scholar
  38. 38.
    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 125:411–416PubMedCrossRefGoogle Scholar
  39. 39.
    Todd TW (1937) Atlas of skeletal maturation: 1 The hand. C.V. Mosby Comp, St. LouisGoogle Scholar
  40. 40.
    Thiemann H-H, Nitz I, Schmeling A (2006) Röntgenatlas der normalen Hand im Kindesalter. Thieme, StuttgartGoogle Scholar
  41. 41.
    Weber R (1978). Genauigkeit der Skelettalterbestimmungen und Größenprognosen nach den Methoden von Greulich & Pyle sowie Tanner & Whitehouse. Diss, Freie Universität, BerlinGoogle Scholar
  42. 42.
    Wirtz M, Caspar F (2002) Beurteilerübereinstimmung und Beurteilerreliabilität. Hogrefe-Verlag, Göttingen, pp 157–235Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • S. Schmidt
    • 1
    Email author
  • I. Nitz
    • 2
  • S. Ribbecke
    • 3
  • R. Schulz
    • 1
  • H. Pfeiffer
    • 1
  • A. Schmeling
    • 1
  1. 1.Institute of Legal MedicineMünster University HospitalMünsterGermany
  2. 2.BerlinGermany
  3. 3.Dr. Gladitz Statistical ServiceBerlinGermany

Personalised recommendations