Age Estimation from Radiographic Images of the Knee

This study examines the reliability of age estimation utilizing the Pyle and Hoerr atlas in relation to a modern Scottish population. The knee radiographs of 442 individuals (168 females, 274 males) were age assessed using the Pyle and Hoerr atlas. Analysis showed that there was a strong correlation between chronological age and estimated age (females R² = 0.968, males R² = 0.952). For females, the atlas method was most accurate between the ages of 9 and 15 years of age with an underage of 2.27 months and an overage of 2.38 months. For males, the atlas consistently overestimated age from the age of 9 years to the age of 16 years from between 0.14 and 8.81 months. The standard deviation for females was 9.86 months and for males was 10.75 months. This study showed that the Pyle and Hoerr atlas can be applied to a modern population with small modifications.     

Does Mirror Imaging a Radiograph Affect Reliability of Age Assessment Using the Greulich and Pyle Atlas?*

Abstract: Age estimation is routinely undertaken by comparing radiographs of the individual in question to published reference samples of individuals of known age. This study examines the reliability of age estimation utilizing the Greulich and Pyle atlas in relation to both left‐ and right‐hand/wrist radiographs and explores whether reversing right‐hand/wrist radiographs, so that they are in the same anatomical orientation as those images used in the atlas affects reliability. A total of 403 left‐hand/wrist radiographs and 415 right‐hand/wrist radiographs were age assessed using the Greulich and Pyle atlas. Analysis showed that there is no significant loss in reliability when radiographs of the right hand (women R² = 0.887 and men R² = 0.907) are utilized instead of the left (women R² = 0.939 and men R² = 0.940) or when they are assessed as mirror images to those printed in the reference atlas (reversed female left hand R² = 0.929 and reversed male left hand R² = 0.931).     

Applicability of Greulich and Pyle skeletal age standards to Indian children

A total 375 Indian children of age 1 day to 19 years were studied (male 194 and female 181). For determining the bone age (skeletal age), wrist and hand radiographs were taken. The skeletal age was determined by blinded review of radiograph using Greulich and Pyle atlas (2nd edition, 1959). If we consider all age group (1-19 years), the Indian boys were retarded in skeletal age by 0.7 years and females by 0.33 years. Male and female children skeletally lag behind the American standard (GP Atlas) in all age groups except 12-13 years age group in which girls are accelerated by 0.22 years. Chronological age and skeletal age difference of more than 1 year is seen between age group 7 years and 12 years in males. Females after second year showed a retardation, which ranged from 0.2 to 0.8 years, up to the age of 19 years. The present study concludes that, Greulich and Pyle atlas is not applicable to the Indian children of both sexes especially in middle and late childhood.     

Epiphyseal Union of the Cervical Vertebral Centra: Its Relationship to Skeletal Age and Maturation of Thoracic Vertebral Centra

Epiphyseal union stages for cervical vertebral centra (ring epiphyses) were documented for 55 individuals (females and males, ages 14–27 years) from the Terry Collection, using the Albert and Maples method 1, to examine both its relationship to age at death and to thoracic data collected from the same individuals using the same method. Results showed a moderate correlation between cervical ring union and age (r = 0.63, p = 0.000), and a fairly low correlation between cervical and thoracic ring union (r = 0.41, p = 0.002). Paired samples t‐tests yielded a statistically significant difference between cervical and thoracic union mean values (p = 0.01). Union progressed earlier in cervical vertebrae and in females. Results indicated fairly substantial variation in both sexes. Findings may serve as a basic guideline for estimating a general age range at death for unknown skeletal remains and to corroborate findings from other skeletal age indicators.     

Quantification of Pubic Symphysis Metamorphosis Based on the Analysis of Clinical MDCT Scans in a Contemporary Malaysian Population

Forensic age estimation methods are biased to sex and population; in general, accuracy is reduced when applied to foreign populations. This study assessed the accuracy of the Suchey–Brooks method in contemporary Malaysian individuals and aimed to formulate population‐specific standards. Multi‐detector computed tomography scans of 355 individuals (165 male; 190 female) of 15–83 years of age were reconstructed using 3D‐volumetric rendering in RadiAnt. Pubic symphyseal phase, bias, inaccuracy, and percentage correct age classifications are examined. Transition analysis was used to develop age estimation standards. High observer agreement (κ = 0.763–0.832) and a positive relationship between age and pubic symphyseal phase (r = 0.884–0.90) were demonstrated. Mean inaccuracies were 8.62 and 8.95 years for males and females, respectively; overall correct classification was 97.8%. Transition ages between phases in males were 18.79, 23.29, 28.85, 43.64, and 61.15 years; in females, the corresponding data were 19.77, 22.53, 32.62, 41.85, and 57.39 years.     

The Effects of Racemization Rate for Age Estimation of Pink Teeth

Pink teeth is thought to result from the seepage of hemoglobin caused by dental pulp decomposition. We investigated whether racemization can be applied for age estimation in cases of pink teeth where the whole tooth is used. The pink teeth used were three cases and the normal teeth for control were five mandibular canines of known age. Age of the pink teeth was calculated on the basis of regression formula obtained from the five control teeth. Only a slight error was noted between the actual and estimated ages of the pink teeth (R² = 0.980, r = 0.990): Cases 1–3 actually aged 23, 53, and 59 years were estimated to be 26, 52, and 60 years. Based on our results of testing pink teeth of known age, we suggest that racemization techniques allow for the age estimation of pink teeth using the same methods for normally colored teeth.     

In Vivo Facial Tissue Depth for Canadian Aboriginal Children: A Case Study from Nova Scotia,Canada

This study examines facial tissue depth in Canadian Aboriginal children. Using ultrasound, measurements were taken at 19 points on the faces of 392 individuals aged 3–18 years old. The relationships between tissue thickness, age, and sex were investigated. A positive linear trend may exist between tissue thickness and age for Aboriginal females and males at multiple points. No points show significant differences in facial tissue depth between males and females aged 3–8 years old; seven points show significant differences in facial tissue depth between males and females aged 9–13 years old; and five points show significant differences in facial tissue depth between males and females aged 14–18 years old. Comparisons were made with White Americans and African Nova Scotians. These data can assist in 3‐D facial reconstructions and aid in establishing an individual's identity. Previously, no data existed for facial tissue thickness in Canadian Aboriginal populations.     

Forensic Dental Age Estimation by Measuring Root Dentin Translucency Area Using a New Digital Technique

Dentin translucency measurement is an easy yet relatively accurate approach to postmortem age estimation. Translucency area represents a two‐dimensional change and may reflect age variations better than length. Manually measuring area is challenging and this paper proposes a new digital method using commercially available computer hardware and software. Area and length were measured on 100 tooth sections (age range, 19–82 years) of 250 μm thickness. Regression analysis revealed lower standard error of estimate and higher correlation with age for length than for area (R = 0.62 vs. 0.60). However, test of regression formulae on a control sample (n = 33, 21–85 years) showed smaller mean absolute difference (8.3 vs. 8.8 years) and greater frequency of smaller errors (73% vs. 67% age estimates ≤ ±10 years) for area than for length. These suggest that digital area measurements of root translucency may be used as an alternative to length in forensic age estimation.     

RUS-CHN图谱骨龄评价法用于推侧青少年年龄

目的探讨RUS-CHN(RC)图谱评价法用于13~18岁青少年年龄推侧的应用价值。方法4 424名(男2 272,女2 152)13~18岁正常城市汉族青少年,以简化RUS-CHN法建立手腕骨发育等级图谱。另以1 048名(男530,女518)13~18岁青少年为检验样本,比较不同方法骨龄与生活年龄的差异。结果RUS-CHN图谱法可仅评价桡骨、尺骨远端和第III指的4块掌指骨骺。检验样本中男14~17岁、女13~16岁年龄组,RC图谱法骨龄与生活年龄之间的差异均无统计学显著性(W ilcoxon符号秩和检验,P>0.05),对男18岁、女17岁组出现显著性差异的可能原因进行了讨论。结论RUS-CHN图谱法骨龄适用于男13~18岁、女13~17岁青少年的年龄推测。     

Dental Age Estimation: A Test of the Reliability of Correctly Identifying a Subject Over 18 Years of Age Using the Gold Standard of Chronological Age as the Comparator

This study was designed to test the reliability of using the third molars to demarcate between child and adult status. A total of 2000 dental panoramic tomographs were used for assessment of the calculated age using the 8‐stage system of tooth development and applied to all four third molars. The LL8 was also assessed using this 8‐stage system. For each tooth development stage, the Normal distribution and percentile summary data were estimated. The calculated dental age compared with the chronological age was statistically significantly different (p < 0.001) for both females and males giving underestimates of the true age. Comparison of single tooth dental age and chronological age was only slightly different. The most important finding is that the assignment to above or below the 18‐year threshold, in the age range 17 years to 19 years, could be wrong on up to 50% of occasions.     

Introducing Computed Tomography Standards for Age Estimation of Modern Australian Subadults Using Postnatal Ossification Timings of Select Cranial and Cervical Sites,

Contemporary, population‐specific ossification timings of the cranium are lacking in current literature due to challenges in obtaining large repositories of documented subadult material, forcing Australian practitioners to rely on North American, arguably antiquated reference standards for age estimation. This study assessed the temporal pattern of ossification of the cranium and provides recalibrated probabilistic information for age estimation of modern Australian children. Fusion status of the occipital and frontal bones, atlas, and axis was scored using a modified two‐ to four‐tier system from cranial/cervical DICOM datasets of 585 children aged birth to 10 years. Transition analysis was applied to elucidate maximum‐likelihood estimates between consecutive fusion stages, in conjunction with Bayesian statistics to calculate credible intervals for age estimation. Results demonstrate significant sex differences in skeletal maturation (p < 0.05) and earlier timings in comparison with major literary sources, underscoring the requisite of updated standards for age estimation of modern individuals.     

Comparison of the three age estimation methods: Which is more reliable for Turkish children?

BackgroundThree atlases—the GÖK, the Greulich–Pyle (GP), and the Tanner–Whitehouse (TW3)—are used frequently for age determination in Turkey. The purpose of this study was to evaluate the applicability of these three methods related to the skeletal age assessment for Turkish adolescents.Materials and methodsThe conventional roentgenograms of the left hands and wrists, elbows, shoulders, and pelvises of 333 healthy Caucasian children (164 females, 169 males) who fit the study and the criteria of each atlas were obtained. The mean differences (± standard deviation [S.D.] in years) between the chronologic age (CA) and the skeletal age (BA), which were obtained by using each age estimation method, were calculated and tested using t-test.ResultsFor girls, the most accurate method was the TW3 (mean differences (d): ?0.21 (p < 0.05)), following by the GP (d: 0.66 (p < 0.001), and the GÖK (d: 2.99 (p < 0.001)). For boys, the most accurate method was the GP (d: ?0.02 (p > 0.05)), followed by the TW3 (d: ?0.18 (p < 0.05)) and GÖK (d: 1.05 (p < 0.001)).Discussion and conclusionsResults show that the TW3 (for girls) and the GP (for boys) methods are more appropriate than the GÖK atlas for estimating the BA. GÖK could be used for boys aged 11–14 years but it should not be used for girls.     

The Utility of the Proximal Epiphysis of the Fifth Metatarsal in Age Estimation

Radiographs of 277 living individuals were assessed via a numerical scoring system to determine the timing of appearance and degree of fusion between the proximal epiphysis of the fifth metatarsal and its diaphysis. The epiphysis was observed to first appear in females at 8 years and 10 years in males and fuse by 14 years in females and 15 years in males. When assessing the level of agreement of category assignment, inter‐observer agreement was 78% for females and 64% for males whereas intra‐observer agreement was 77% for females and 86.1% for males. These results suggest that the maturation of the proximal epiphysis of the fifth metatarsal may be of value in age estimation in the child and that the scoring system is sufficiently robust to merit continued investigation. Previously this epiphysis has been considered an inconstant feature, but this research confirmed its presence in all individuals studied.     

The Use of CT Scans in Estimating Age at Death by Examining the Extent of Ectocranial Suture Closure

We examined the utility of CT scans in the evaluation of degree of ectocranial suture closure. Five cranial points (left and right midcoronal positions, left and right midlambdoidal positions, and the lambda) were evaluated in 231 CT scans using a three‐point scoring system (open, partial closed, and closed). The slice increment and thickness varied between three groups of the scans. The results showed a good correlation between degree of suture closure and increasing age in each group. Young individuals (<40 years) and old individuals (>60 years) could be clearly distinguished from the middle‐aged individuals. ANOVA test revealed no difference between two groups of scans and between left and right sides (p > 0.05). Interobserver agreement was good, especially considering the score by sides. The results of this study create the base for developing a robust and simple method to estimate the age at death using CT scans.     

Relationship Between Pulp Tooth Area Ratio and Chronological Age Using Cone‐beam Computed Tomography Images

This study investigated the relationship between chronological age and pulp tooth area ratio (PTR) in maxillary central teeth using cone‐beam computed tomography (CBCT) images in the Turkish population. The sample consisted of CBCT images of 120 male and female subjects between 14 and 75 years old. The PTR of the maxillary central teeth was calculated using inVivo 5 software (Anatomage, San Jose, CA). Data were analyzed with independent t‐test and Pearson's rank correlation test. There was a significant negative correlation between chronological age and PTR (r = ?0.615). The results showed that the PTR of maxillary central teeth is a reliable method for age estimation in the Turkish population.     

Validation of the Acetabulum As a Skeletal Indicator of Age at Death in Modern European‐Americans,

Progressive changes in the acetabulum have been used in modern skeletal age estimation, but they have not been completely understood. If their age correlations are weakened by the influence of factors like physical activity and obesity, acetabular changes should not be used for age estimation. To investigate their utility for aging, the acetabular variables of Rissech et al. (2006) were analyzed in 409 modern European‐Americans (Bass Collection, Tennessee). Correlation tests assessed potential associations between acetabular data, osteoarthritis scores (collected per Jurmain, 1990), and documented demographic information (age, body mass index [BMI], metabolic intensity of physical activities). Acetabular changes had statistically significant, positive correlations with osteoarthritis (p < 0.001 in most joints/regions) and age (p < 0.001), indicating their degenerative nature and relevance for age estimation. Acetabular changes showed no associations with BMI or metabolic values, suggesting resistance to obesity and activity effects. These results suggest that acetabular degeneration is a valid skeletal age‐at‐death indicator.     

An Evaluation of Statistical Methods for the Determination of Age of Death Using Dental Root Translucency and Periodontosis

Abstract: Lamendin and colleagues (1992) proposed to assess age‐at‐death from root translucency and periodontosis. Several teeth from the same individual were included in their study. In our work, we evaluate the reliability of their formulas without introducing this bias. Our sample was constituted of 214 individuals (114 males and 100 women) selected from the Terry collection (U.S.A.). The R² between age and both indicators is equal to 0.33 and 0.08 (p < 0.001). Based on linear regression, the mean of standard error for individual age prediction was equal to 13.67 years, and the mean interval length is equal to 53.89 years. Multinomial logistic regression and Bayesian approach failed to give satisfactory results when classifying the individuals in age categories. Therefore, the use of root translucency and periodontosis may lead to incorrect age‐at‐death assessment, and it is thus necessary to complement this approach with other techniques to assess age‐at‐death.     

Microscopic Age Estimation from the Anterior Cortex of the Femur in Korean Adults*

Abstract: The purpose of this study was to develop age‐predicting equations from the anterior cortex of the femur of Korean adults. Seventy‐two femoral samples (44 male and 28 female) were obtained from Korean cadavers and used to develop the equations. The thin sections (<100‐μm thick) were prepared by manual grinding; the sections were not decalcified and were stained with Villanueva bone stain reagent. Analysis of covariance showed no significant differences in age‐adjusted histomorphological variables between sexes. In stepwise regression analysis, osteon population density, average osteon area, and the most anterior cortical width were selected for an age‐predicting equation which produced a high regression correlation (R² = 0.789). The average Haversian canal area was not significantly related to age for any specimen.