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Magnetic resonance imaging-based evaluation of ossification of the medial clavicular epiphysis in forensic age assessment

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Abstract

Evaluation of the degree of ossification of the medial clavicular epiphysis plays a crucial role in determining with an adequate degree of probability whether legally relevant age boundaries after the age of 17 have been crossed. In view of the need to avoid unnecessary radiation exposure, establishing non-X-ray methods for investigating the clavicle has long been a key objective in forensic age assessment research. Based on magnetic resonance imaging examinations in a large sample of healthy subjects, the current study for the first time presents statistical measures which allow inferences to be drawn for forensic age assessment in both sexes. We undertook a prospective study of a reference sample of 334 female and 335 male German volunteers aged from 12 to 24 using a 3-T MRI scanner. A 3D FFE (fast field echo) T1-weighted sequence with fat saturation was acquired. To stage ossification of the medial clavicular epiphysis, we used the clavicular ossification staging systems described by Schmeling et al. and Kellinghaus et al. Ossification stage IIIc offers a means in both sexes of demonstrating that the age of 18 has been attained prior to complete ossification of the epiphyseal plate. In both sexes, if a subject has reached ossification stage IV, it can be stated that he or she has attained the age of 21. Magnetic resonance imaging is a valid diagnostic procedure for determining the ossification stage of the medial clavicular epiphysis.

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References

  1. Ogden JA, Conlogue GJ, Bronson ML (1979) Radiology of postnatal skeletal development. III. The clavicle. Skelet Radiol 4:196–203

    Article  CAS  Google Scholar 

  2. Schmeling A, Schmidt S, Schulz R, Wittschieber D, Rudolf E (2014) Studienlage zum zeitlichen Verlauf der Schlüsselbeinossifikation. Rechtsmedizin 24:467–474

    Article  Google Scholar 

  3. Jit I, Kulkarni M (1976) Times of appearance and fusion of epiphysis at the medial end of the clavicle. Indian J Med Res 64:773–782

    CAS  PubMed  Google Scholar 

  4. Kellinghaus M, Schulz R, Vieth V, Schmidt S, Pfeiffer H, Schmeling A (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124:321–325

    Article  PubMed  Google Scholar 

  5. Kellinghaus M, Schulz R, Vieth V, Schmidt S, Schmeling A (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med 124:149–154

    Article  PubMed  Google Scholar 

  6. Kreitner KF, Schweden F, Riepert T, Nafe B, Thelen M (1998) Bone age determination based on the study of the medial extremity of the clavicle. Eur Radiol 8:1116–1122

    Article  CAS  PubMed  Google Scholar 

  7. Schmeling A, Schulz R, Reisinger W, Mühler M, Wernecke KD, Geserick G (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118:5–8

    Article  PubMed  Google Scholar 

  8. Schulz R, Mühler M, Mutze S, Schmidt S, Reisinger W, Schmeling A (2005) Studies on the time frame for ossification of the medial epiphysis of the clavicle as revealed by CT scans. Int J Legal Med 119:142–145

    Article  PubMed  Google Scholar 

  9. Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) 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

    Article  PubMed  Google Scholar 

  10. Wittschieber D, Ottow C, Vieth V, Küppers M, Schulz R, Hassu J, Bajanowski T, Püschel K, Ramsthaler F, Pfeiffer H, Schmidt S, Schmeling A (2015) Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 129:187–193

    Article  PubMed  Google Scholar 

  11. 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) Aktualisierte Empfehlungen der Arbeitsgemeinschaft für Forensische Altersdiagnostik für Altersschätzungen bei Lebenden im Strafverfahren. Rechtsmedizin 18:451–453

    Article  Google Scholar 

  12. Quirmbach F, Ramsthaler F, Verhoff MA (2009) Evaluation of the ossification of the medial clavicular epiphysis with a digital ultrasonic system to determine the age threshold of 21 years. Int J Legal Med 123:241–245

    Article  PubMed  Google Scholar 

  13. Schulz R, Zwiesigk P, Schiborr M, Schmidt S, Schmeling A (2008) Ultrasound studies on the time course of clavicular ossification. Int J Legal Med 122:163–167

    Article  PubMed  Google Scholar 

  14. Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A (2013) Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals. Forensic Sci Med Pathol 9:351–357

    Article  PubMed  Google Scholar 

  15. Schmidt S, Mühler M, Schmeling A, Reisinger W, Schulz R (2007) Magnetic resonance imaging of the clavicular ossification. Int J Legal Med 121:321–324

    Article  PubMed  Google Scholar 

  16. Hillewig E, De Tobel J, Cuche O, Vandemaele P, Piette M, Verstraete K (2011) Magnetic resonance imaging of the medial extremity of the clavicle in forensic bone age determination: a new four-minute approach. Eur Radiol 21:757–767

    Article  PubMed  Google Scholar 

  17. Hillewig E, Degroote J, van der Paelt T, Visscher A, Vandemaele P, Lutin B, D’Hooghe L, Vandriessche V, Piette M, Verstraete K (2013) Magnetic resonance imaging of the sternal extremity of the clavicle in forensic age estimation: towards more sound age estimates. Int J Legal Med 127:677–689

    Article  CAS  PubMed  Google Scholar 

  18. Hollnberger J (2011) Validierung der Ossifikation der medialen Claviculaepiphyse mit der Magnetresonanztomografie. Dissertation, Jena

  19. Schmidt S, Henke CA, Wittschieber D, Vieth V, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmeling A, Schulz R (2016) Optimising magnetic resonance imaging-based evaluation of the ossification of the medial clavicular epiphysis. A multi-centre study. Int J Legal Med 130:1615–1621

    Article  CAS  PubMed  Google Scholar 

  20. Tangmose S, Jensen KE, Lynnerup N (2013) Comparative study on developmental stages of the clavicle by postmortem MRI and CT imaging. J Forensic Radiol Imaging 1:102–106

    Article  Google Scholar 

  21. Tangmose S, Jensen KE, Villa C, Lynnerup N (2014) Forensic age estimation from the clavicle using 1.0T MRI—preliminary results. Forensic Sci Int 234:7–12

    Article  PubMed  Google Scholar 

  22. Vieth V, Schulz R, Brinkmeier P, Dvorak J, Schmeling A (2014) Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle. Forensic Sci Int 241:118–122

    Article  PubMed  Google Scholar 

  23. Wittschieber D, Vieth V, Timme M, Dvorak J, Schmeling A (2014) Magnetic resonance imaging of the iliac crest: age estimation in under-20 soccer players. Forensic Sci Med Pathol 10:198–202

    Article  PubMed  Google Scholar 

  24. Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V (2014) Forensic age estimation in living individuals using 3.0 T MRI of the distal femur. Int J Legal Med 128:509–514

    Article  PubMed  Google Scholar 

  25. Krämer JA, Schmidt S, Jürgens KU, Lentschig M, Schmeling A, Vieth V (2014) The use of magnetic resonance imaging to examine ossification of the proximal tibial epiphysis for forensic age estimation in living individuals. Forensic Sci Med Pathol 10:306–313

    Article  PubMed  Google Scholar 

  26. Guo Y, Olze A, Ottow C, Schmidt S, Schulz R, Heindel W, Pfeiffer H, Vieth V, Schmeling A (2015) Dental age estimation in living individuals using 3.0 T MRI of lower third molars. Int J Legal Med 129:1265–1270

    Article  PubMed  Google Scholar 

  27. Schmidt S, Vieth V, Timme M, Dvorak J, Schmeling A (2015) Examination of ossification of the distal radial epiphysis using magnetic resonance imaging. New insights for age estimation in young footballers in FIFA tournaments. Sci Justice 55:139–144

    Article  CAS  PubMed  Google Scholar 

  28. Timme M, Ottow C, Schulz R, Pfeiffer H, Heindel W, Vieth V, Schmeling A, Schmidt S (2017) Magnetic resonance imaging of the distal radial epiphysis: a new criterion of maturity for determining whether the age of 18 has been completed? Int J Legal Med 131:579-584

  29. Gelbrich B, Lessig R, Lehmann M, Dannhauer K-H, Gelbrich G (2010) Altersselektion in Referenzstichproben. Auswirkung auf die forensische Altersschätzung. Rechtsmedizin 20:459–463

    Article  Google Scholar 

  30. Link TM, Vieth V, Stehling C, Lotter A, Beer A, Newitt D, Majumdar S (2003) High-resolution MRI vs multislice spiral CT: which technique depicts the trabecular bone structure best? Eur Radiol 13:663–671

    PubMed  Google Scholar 

  31. Owings Webb PA, Myers Suchey J (1985) Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females. Am J Phys Anthropol 68:457–466

    Article  Google Scholar 

  32. Wittschieber D, Schulz R, Pfeiffer H, Schmeling A, Schmidt S (2016) Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics. Int J Legal Med 131:217–224

    Article  PubMed  Google Scholar 

  33. Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) Influence of the examiner’s qualification and sources of error during stage determination of the medial clavicular epiphysis by means of computed tomography. Int J Legal Med 128:183–191

    Article  PubMed  Google Scholar 

  34. 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 125:411–416

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by the European Refugee Fund, the German Federal Office for Migration and Refugees and the Westphalian Wilhelms University of Münster, Germany.

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Authors and Affiliations

  1. Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, 48149, Münster, Germany

    S. Schmidt, H. Pfeiffer, A. Schmeling & R. Schulz

  2. Institut für Klinische Radiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany

    C. Ottow, W. Heindel & V. Vieth

  3. Klinikum Ibbenbüren GmbH, Große Straße 41, 49477, Ibbenbüren, Germany

    V. Vieth

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  1. S. Schmidt
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  2. C. Ottow
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  3. H. Pfeiffer
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  4. W. Heindel
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  5. V. Vieth
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  6. A. Schmeling
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  7. R. Schulz
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Correspondence to A. Schmeling.

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The research project was approved by the Ethics Committee of the Medical Faculty of the University of Münster. Written consent was obtained from all participants in the study (in the case of minors from their parents) prior to their participation in the study.

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Schmidt, S., Ottow, C., Pfeiffer, H. et al. Magnetic resonance imaging-based evaluation of ossification of the medial clavicular epiphysis in forensic age assessment. Int J Legal Med 131, 1665–1673 (2017). https://doi.org/10.1007/s00414-017-1676-5

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  • DOI: https://doi.org/10.1007/s00414-017-1676-5

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