title: Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography.
abstract: Radiological assessment of the degree of ossification of the medial clavicular epiphyseal cartilage plays a vital part in forensic age diagnosis of living adolescents and young adults. A total of 873 plain chest radiographs requested by the staff medical officer for members of staff aged 16-30 at the University Hospital Charité were evaluated retrospectively. Of these X-rays 699 permitted an assessment of ossification of at least 1 side of the clavicle. In addition to the customary stages (1: non-ossified epiphysis, 2: discernible ossification centre, 3: partial fusion, 4: total fusion) a stage 5 was also defined, characterised by the disappearance of the epiphyseal scar following total fusion. The earliest age at which stage 3 was detected in either gender was 16 years. Stage 4 was first observed in women at 20 years and in men at 21 years. In both genders, the earliest observation of stage 5 was at 26 years. It was concluded that plain chest radiographs can essentially be used to assess clavicular ossification. In practice, if overlap in posterior-anterior views impedes evaluation, a lateral view should also be taken to facilitate age estimation. In forensic practice the reference values of the present paper should be applied.
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Charité der Humboldt-Universität zu Berlin, Hannoversche Strasse 6, 10015 Berlin, Germany. andreas.schmeling@charite.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Schmeling
authors.forename: Ronald
authors.initials: R
authors.lastname: Schulz
authors.forename: Walter
authors.initials: W
authors.lastname: Reisinger
authors.forename: Matthias
authors.initials: M
authors.lastname: Mühler
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Gunther
authors.initials: G
authors.lastname: Geserick
mesh_terms: D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002968:Clavicle / Q000000981:diagnostic imaging*; D005260:Female; D005554:Forensic Medicine / Q000379:methods; D006132:Growth Plate / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D010012:Osteogenesis