Age estimation using ankle radiographic examination in a contemporary Thai population

Authors

  • Aekawit Triamkitsawat Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Dittapong Songsaeng Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Vijarn Vachirawongsakorn Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Age estimation, epiphysis, tibia, fibula, radiograph

Abstract

Background: Radiologic evaluation of skeletal maturity is one of the three practical methods to assess age in a living person.

Objective: To assess the average age from the epiphyseal fusion of the distal tibia and fibula in Thai children and young adults.

Methods: Ankle radiographs of 217 Thai patients aged 0 to 22 years who came to Siriraj Hospital from 1 January 2000 to 31 March 2020 were recruited for the study. The development of epiphyseal plate in the distal tibia and fibula was analyzed as a grading system. A composite score was also calculated. The relationship between age, the fusion stage and the composite score was explored.

Results: The results showed that the complete fusion of the distal tibia and fibula in females and males was found as early as 12 and 13 years, respectively. All females exhibited complete fusion by 15 years old in both epiphyses. All males showed complete fusion of distal tibia and fibula by 15 and 16 years, respectively. The fusion stage tended to rise with the increasing age. There was a significant difference between male and female data. The reliability test showed excellent agreement.

Conclusion: Ankle radiographs can essentially be used to assess distal tibia and fibula ossification. The reference values given in this study can be used in age estimation for the Thai population.

Downloads

Download data is not yet available.

References

Black S, Aggrawal A, Payne-James JJ, editors. Age estimation in the living: The practitioner's guide. Hoboken, NJ: Wiley-Blackwell; 2010.

https://doi.org/10.1002/9780470669785

Santos C, Ferreira M, Alves FC, Cunha E. Comparative study of greulich and pyle atlas and maturos 4.0 program for age estimation in a portuguese sample. Forensic Sci Int 2011;212:276.e1-7. https://doi.org/10.1016/j.forsciint.2011.05.032

Schmidt S, Nitz I, Ribbecke S, Schulz R, Pfeiffer H, Schmeling A. Skeletal age determination of the hand: a comparison of methods. Int J Legal Med 2013;127:691-8. https://doi.org/10.1007/s00414-013-0845-4

Darmawan MF, Yusuf SM, Abdul Kadir MR, Haron H. Age estimation based on bone length using 12 regression models of left hand X-ray images for Asian children below 19 years old. Leg Med (Tokyo) 2015;17:71-8. https://doi.org/10.1016/j.legalmed.2014.09.006

Schmeling A, Schulz R, Reisinger W, Mühler M, Wernecke KD, Geserick G. Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 2004;118:5-8. https://doi.org/10.1007/s00414-003-0404-5

Wittschieber D, Ottow C, Vieth V, Küppers M, Schulz R, Hassu J, et al. Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 2015;129:187-93. https://doi.org/10.1007/s00414-014-1067-0

Zhang K, Chen XG, Zhao H, Dong XA, Deng ZH. Forensic age estimation using thin-slice multidetector CT of the clavicular epiphyses among adolescent Western Chinese. J Forensic Sci 2015;60:675-8. https://doi.org/10.1111/1556-4029.12739

Pattamapaspong N, Madla C, Mekjaidee K, Namwongprom S. Age estimation of a Thai population based on maturation of the medial clavicular epiphysis using computed tomography. Forensic Sci Int 2015;246:123.e1-5. https://doi.org/10.1016/j.forsciint.2014.10.044

Cameriere R, Giuliodori A, Zampi M, Galic I, Cingolani M, Pagliara F, et al. Age estimation in children and young adolescents for forensic purposes using fourth cervical vertebra (C4). Int J Legal Med 2015;129:347-55. https://doi.org/10.1007/s00414-014-1112-z

de Oliveira FT, Soares MQ, Sarmento VA, Rubira CM, Lauris JR, Rubira- Bullen IR, Mandibular ramus length as an indicator of chronological age and sex. Int J Legal Med 2015;129:195-201. https://doi.org/10.1007/s00414-014-1077-y

Scoles PV, Salvagno R, Villalba K, Riew D. Relationship of iliac crest maturation to skeletal and chronologic age. J Pediatr Orthop 1988;8:639-44. https://doi.org/10.1097/01241398-198811000-00002

Wittschieber D, Vieth V, Domnick C, Pfeiffer H, Schmeling A. The iliac crest in forensic age diagnostics: evaluation of the apophyseal ossification in conventional radiography. Int J Legal Med 2013;127: 473-9. https://doi.org/10.1007/s00414-012-0763-x

Fan F, Zhang K, Peng Z, Cui JH, Hu N, Deng ZH. Forensic age estimation of living persons from the knee: Comparison of MRI with radiographs. Forensic Sci Int 2016;268:145-50. https://doi.org/10.1016/j.forsciint.2016.10.002

Banerjee KK, Agarwal BB. Estimation of age from epiphyseal union at the wrist and ankle joints in the capital city of India. Forensic Sci Int 1998;98:31-9. https://doi.org/10.1016/S0379-0738(98)00134-0

Crowder C, Austin D. Age ranges of epiphyseal fusion in the distal tibia and fibula of contemporary males and females. J Forensic Sci 2005;50:1-7. https://doi.org/10.1520/JFS2004542

Ding KY, Dahlberg PS, Rolseth V, Mosdøl A, Straumann GH, Bleka Ø, et al. Development stages of the knee and ankle by computed tomography and magnetic resonance imaging for estimation of chronological age: a systematic review. Report 2018. Oslo: Norwegian Institute of Public Health; 2018.

Patond S, Tirpude BH, Murkey P, Wankhade P, Nagrale N, Surwade V. Age determination from epiphyseal union of bones at ankle joint in girls of central India. J Forensic Med Sci Law 2012;21:11-6.

Saint-Martin P, Rérolle C, Dedouit F, Bouilleau L, Rousseau H, Rougé D, et al. Age estimation by magnetic resonance imaging of the distal tibial epiphysis and the calcaneum. Int J Legal Med 2013;127:1023-30. https://doi.org/10.1007/s00414-013-0844-5

Ruensuk S, Vachirawongsakorn V. Age estimation from radiographic analysis of epiphyseal fusion at the knee joint in Thai population. JFPAT 2018; 12:21-33.

Benjavongkulchai S, Pittayapat P. Age estimation methods using hand and wrist radiographs in a group of contemporary Thais. Forensic Sci Int 2018;287:218.e1-.e8. https://doi.org/10.1016/j.forsciint.2018.03.045

Hoerr NL, Pyle SI, Francis CC. Radiographic atlas of skeletal development of the foot and ankle: A standard of reference. Springfield, IL: Charles C. Thomas;1962.

Scheuer L, Black S. Developmental juvenile osteology. Cambridge, MA:Academic Press, 2000. https://doi.org/10.1016/B978-012624000-9/50004-6

Schmeling A, Reisinger W, Geserick G, Olze A. Age estimation of unaccompanied minors. Part I. General considerations. Forensic Sci Int 2006;159 Suppl 1:S61-4. https://doi.org/10.1016/j.forsciint.2006.02.017

Iscan MY. Age markers in the human skeleton. Springfield, IL:Charles C Thomas;1989.

Ousley SD, Jantz RL. The forensic data bank: Documenting skeletal trends in the United States. In: Reichs KJ, editor. Forensic osteology: Advances in the identiûcation of human remains. 2nd ed. Springûeld, IL: Charles C Thomas;1999. p. 454-8.

Meadows MA, Jantz RL. Allometric secular change in the long bones from the 1800s to the present. J Forensic Sci 1995;40:762-7.

https://doi.org/10.1520/JFS15380J

De Angelis D, Messina C, Sconfienza L, Sardanelli F, Cattaneo C, Gibelli D. Forensic radiology and identification. In: Lo Re G, Argo A, Midiri M, Cattaneo C, editors. Radiology in forensic medicine: From identification to post-mortem imaging. Springer Nature Switzerland;2020. p.63-85. https://doi.org/10.1007/978-3-319-96737-0_8

Downloads

Published

2023-07-17

How to Cite

1.
Triamkitsawat A, Songsaeng D, Vachirawongsakorn V. Age estimation using ankle radiographic examination in a contemporary Thai population. Chula Med J [Internet]. 2023 Jul. 17 [cited 2024 May 20];66(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/76