Skeletal age determination in adolescents involved in judicial procedures: from evidence-based principles to medical practice.
BACKGROUND
The ideal basis of age estimation is considered to be a combination of clinical, skeletal and dental examinations. It is not easy to determine how forensic physicians take account of evidence-based data obtained from medical journals in their medical decision-making. The question of what is an ethically acceptable probability that adolescents are incorrectly considered to be over 18 has not been answered.


METHODS
In a retrospective study over 1 year (2007), 498 files (for 141 female subjects and 357 male subjects) regarding age assessment requested by the public prosecutor's office for purposes of criminal or asylum proceedings were reviewed. Chronological age was estimated from a combination of physical examination, radiographic examination of the left hand and determination of dental status.


RESULTS
Estimates of chronological age in 498 subjects claiming to be 9-14 years old were incompatible with the alleged age in 356 (71%) when made by the forensic physician but in only 17 (3%) when based on data from published studies on age estimation in adolescents.


CONCLUSIONS
The present study suggests that in most cases the forensic physician ignores the adolescent's word. Medical mission and ethics imply a need to listen to the claims of persons in custody, whatever the risk of false claims. This situation should prompt forensic physicians to keep up with published data on estimating the age of adolescents.
Unit of Forensic Medicine, Hôpital Jean-Verdier (AP-HP), 93143 Bondy, France.
Marie-Odile
MO
Pruvost
Cyril
C
Boraud
Patrick
P
Chariot
D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002648:Child; D057237:Criminals; D003657:Decision Making; D019317:Evidence-Based Medicine; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult