title: [Radiography of the medial ends of the clavicles by the method of the Dutch Immigration and Naturalisation Service is unsuitable for determining adulthood].
abstract: OBJECTIVE
  A critical examination of the radiological technique used by the Dutch Immigration and Naturalisation Service (IND) for determining the adulthood of persons around the age of 18.
  
  
  METHODS
  Descriptive.
  
  
  METHODS
  Radiographs of the hands and clavicles were reassessed in 29 asylum seekers (15 boys, 9 girls and 5 persons of unknown gender) in whom the IND suspected a discrepancy between the true age and the age stated. In each case, 1 hand radiograph and 3 clavicular views were taken: 1 posteroanterior standard view as well as 2 oblique views, in order to assess the epiphyses at the medial ends of the clavicles. Additionally, the radiographs of one of these subjects were shown to 241 radiologists and radiologists-in-training.
  
  
  RESULTS
  On all the hand X-rays, the epiphyses were closed. Based on this, the skeletal age of the girls was at least 15 years and 11 months and that of the boys at least 17 years and 3 months. The medial ends of the clavicles could not be assessed on the standard views due to overprojection of the spinal column. In 55 of the 58 films in which the thorax was turned, the direction of the X-rays was not appropriate for assessing the growth plates. The other 3 could not be assessed as there were no existing objective radiological criteria. The assessments of the stage of development as an indication of skeletal age in the cases presented differed greatly from one another.
  
  
  CONCLUSIONS
  The radiographs that were taken to establish whether or not the asylum seekers were underage were unsuitable for the purpose for which they were taken.
authors.affiliation: Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Radiologie, Meibergdreef 9, 1105 AZ Amsterdam. r.r.vanrijn@amc.uva.nl
authors.forename: R R
authors.initials: RR
authors.lastname: van Rijn
authors.forename: S G F
authors.initials: SG
authors.lastname: Robben
mesh_terms: D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002968:Clavicle / Q000000981:diagnostic imaging*; D004641:Emigration and Immigration; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009426:Netherlands; D012036:Refugees