Ossification stage of the medial clavicular epiphysis

In forensic age estimation of the living in criminal proceedings the radiological examination of the ossification status of the medial clavicular epiphysis permits an assessment with regard to the completion of 21 years of age. In the present study the authors prospectively comparatively analyzed 8 prepared samples of the sternoclavicular region of individuals aged 15-17 years obtained during autopsy by means of projectional radiography, thin-slice computed tomography and magnetic resonance imaging. In 6 out of 15 examined sternoclavicular joints the ossification stage of the medial clavicular epiphysis was in agreement in each of the three imaging methods used. In the remaining cases the ossification stage was assessed as either one stage higher or lower in one of the imaging methods than in the other two techniques. In five cases compared to CT, and seven cases compared to MR, projectional radiography showed a higher ossification stage than CT and MR imaging. In two cases projectional radiography resulted in the determination of a lower stage than in CT and MR imaging. MR scans showed a less advanced ossification stage than CT-based images in two cases. In the practice of age estimation modality-specific reference studies based on projectional radiography and computed tomography are to be applied in order to guarantee an adequate assessment of the ossification stage of the medial clavicular epiphysis.