Abstract
Background
The main importance in age estimation lies in the assessment of criminal liability and protection of unaccompanied minor immigrants, when their age is unknown. Under Italian law, persons are not criminally responsible before they reach the age of 14. The age of 18 is important when deciding whether juvenile or adult law must be applied. In the case of unaccompanied minors, it is important to assess age in order to establish special protective measures, and correct age estimation may prevent a person over 18 from benefiting from measures reserved for minors.
Objective
Since the Greulich and Pyle method is one of the most frequently used in age estimation, the aim of this study was to assess the reproducibility and accuracy of the method on a large Italian sample of teenagers, to ascertain the applicability of the Atlas at the critical age thresholds of 14 and 18 years.
Materials and methods
This retrospective study examined posteroanterior X-ray projections of hand and wrist from 484 Italian–Caucasian young people (125 females, 359 males) between 11 and 19 years old. All radiographic images were taken from trauma patients hospitalized in the Azienda Ospedaliero Universitaria Ospedali Riuniti of Ancona (Italy) between 2006 and 2007. Two physicians analyzed all radiographic images separately. The blind method was used.
Results
In the case of an estimated age of 14 years old, the true age ranged from 12.2 to 15.9 years (median, 14.3 years, interquartile range, 1.0 years) for males, and 12.6 to 15.7 years (median, 14.2 years, interquartile range, 1.7 years) for females. In the case of an estimated age of 18 years, the true age ranged from 15.6 to 19.7 years (median, 17.7 years, interquartile range, 1.4 years) for males, and from 16.2 to 20.0 years (median, 18.7 years, interquartile range, 1.8 years) for females.
Conclusion
Our study shows that although the GPM is a reproducible and repeatable method, there is a wide margin of error in the estimation of chronological age, mainly in the critical estimated ages of 14 and 18 years old in both males and females.
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References
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 Leg Med 122:457–460
Greulic WW, Pyle SI (1959) Radiographic Atlas of Skeletal Development of the Hand and Wrist, Sdth edn. Stanford University Press, Stanford, California
A Papoulis (1991) Probability, Random Variables, and Stochastic Processes, 3rd ed. McGraw-Hill. ISBN 0-07-100870-5. pp. 113–114
Passone C, Pastorin L, Rota A, Fabio Mt, Benso L (1981) Skeletal maturation of the school population of Turin. Comparison between of TW2 and Greulich-Pyle methods. III. 7 and 9-year-old males. Minerva Pediatr 33(9):436–437, 15
Vignolo M, Milani S, Dibattista E, Naselli A, Mostert M, Aicardi G (1990) Modified Greulich-Pyle, Tanner-Whitehouse, and Roche-Wainer-Thissen (knee) methods for skeletal age assessment in a group of Italian children and adolescents. Eur J Pediatr 149(5):314–317
Tanner JM, Whitehouse RH, Cameron N (1990) Valutazione della maturazione scheletrica e predizione dell' altezza adulta (Metodo TW2). Prima edizione italiana, Martinucci Pubblicazioni Mediche, Napoli
Nicoletti I (1991) Crescita e maturazione scheletrica. Età ossea e predizione della statura adulta. Edizioni Centro Studi Auxologici, Firenze
Roche AF, Roberts J, HamillP V (1976) Skeletal maturity of youths 12-17 years, United States. Vital Health Stat 11 160:1–90
Rt L, Dt E, Morrison K, Eggleston D, Dn F, Ml G, Ke G (1993) Applicability of the Greulich and Pyle skeletal age standards to black and white children of today. Am J Dis Child 147(12):1329–1333
Fk O, Ivanovic M, Ds A, Tw B (1996) Bone age in children of diverse ethnicity. AJR Am J Roentgenol 167(6):1395–1398
Mora S, Ines Boechat M, Pietka E, Huang HK, Gilsanz V (2001) Skeletal age determinations in children of European and African descent: applicability of the Greulich and Pyle standards. Pediatr Res 50:624–628
Rikhasor Rm, Qureshi Am, Rathi Sl, Channa Na (1999) Skeletal maturity in Pakistani children. J Anat 195(Pt 2):305–308
Koc A, Karaoglanoglu M, Erdogan M, Kosecik M, Cesur Y (2001) Assessment of bone ages: is the Greulich-Pyle method sufficient for Turkish boys? Pediatr Int 43(6):662–665
Chiang K-H, Chou Andy Shau-Bin, Yen P-S (2005) The reliability of using Greulich-Pyle method to determine children's bone age in Taiwan. Tzu Chi Med J 17:417–420
Lewis CP, Lavy CB, Harrison WJ (2002) Delay in skeletal maturity in Malawian children. J Bone Joint Surg Br 84(5):732–734
Cole TJ, Cole AJ (1992) Bone age, social deprivation, and single parent families. Arch Dis Child 67(10):1281–1285
Schmeling A, Schulz R, Danner B, Rösing FW (2006) The impact of economic progress and modernization in medicine on the ossification of hand and wrist. Int J Leg Med 120(2):121–126
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 Leg Med 113(5):253–258
Kimura K (1977) Skeletal maturity of the hand and wrist in Japanese children in Sapporo by the TW2 method. Ann Hum Biol 4(5):449–453
Kimura K (1977) Skeletal maturity of the hand and wrist in Japanese children by the TW2 method. Ann Hum Biol 4(4):353–356
Greulich WW (1957) A comparison of the physical growth and development of American-born and native Japanese children. Am J Phys Anthropol 15(4):489–515
Ferrante L, Cameriere R (2009) Statistical methods to assess the reliability of measurements in the procedures for forensic age estimation. Int J Leg Med 123(4):277–283
Garamendi PM, Landa MI, Ballesteros J, Solano MA (2005) Reliability of the methods applied to assess age minority in living subjects around 18 years old. A survey on a Moroccan origin population. Forensic Sci Int 154(1):3–12
Büken B, Safak AA, Yazici B, Büken E, Mayda AS (2007) Is the assessment of bone age by the Greulich-Pyle method reliable at forensic age estimation for Turkish children? Forensic Sci Int 173(2-3):146–153
Berst MJ, Dolan L, Bogdanowicz MM, Stevens MA, Chow S, Brandser EA (2001) Effect of Knowledge of Chronologic Age on the Variability of Pediatric Bone Age Determined Using the Greulich and Pyle Standards. AJR 176:507–510
Van Rijn RR, Lequin MH, Robben SG, Hop WC, Van Kuijk C (2001) Is the Greulich and Pyle atlas still valid for Dutch Caucasian children today? Pediatr Radiol 31(10):748–752
Lynnerup N, Belard E, Buch-Olsen K, Sejrsen B, Damgaard-Pedersen K (2008) Intra- and interobserver error of the Greulich-Pyle method as used on a Danish forensic sample. Forensic Sci Int 179(2–3):242–246
Cameriere R, Ferrante L (2008) Age estimation in children by measurement of carpals and epiphyses of radius and ulna and open apices in teeth: a pilot study. Forensic Sci Int 174(1):60–63
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 Leg Med 124(2):149–154
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(4):321–325
Olze A, Solheim T, Schulz R, Kupfer M, Pfeiffer H, Schmeling A (2010) Assessment of the radiographic visibility of the periodontal ligament in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(5):445–448
Olze A, Solheim T, Schulz R, Kupfer M, Schmeling A (2010) Evaluation of the radiographic visibility of the root pulp in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(3):183–186
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Tisè, M., Mazzarini, L., Fabrizzi, G. et al. Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample. Int J Legal Med 125, 411–416 (2011). https://doi.org/10.1007/s00414-010-0541-6
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DOI: https://doi.org/10.1007/s00414-010-0541-6