Skeletal age determination of the hand: a comparison of methods
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ORIGINAL ARTICLE
Skeletal age determination of the hand: a comparison of methods S. Schmidt & I. Nitz & S. Ribbecke & R. Schulz & H. Pfeiffer & A. Schmeling
Received: 20 August 2012 / Accepted: 27 February 2013 / Published online: 13 March 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Until final completion of maturation processes at the age of approximately 18 years, determination of the skeletal age of the hand plays a central role in forensic age diagnostics in living persons in criminal proceedings. In this process, assessment of hand radiographs relies primarily on the stage of development of the epiphyseal nuclei, the increase in size of the individual bones and of the hand skeleton as a whole, changes in the shape of the various skeletal elements and ossification of the epiphyseal plates. To achieve this, there are a variety of methodological approaches based on two different fundamental principles. The methods proposed by Greulich and Pyle, Thiemann et al. and Gilsanz and Ratib rank among the so-called atlas techniques, whilst the methods proposed by Tanner et al. and Roche et al. are classified as so-called bonespecific techniques. In order to be applicable in the field of criminal procedure, the methods of estimating the skeletal age of the hand developed with clinical aspects in mind must satisfy the demands of a high degree of estimate accuracy and good reproducibility of the estimated results. In the course of the present study, a study population of 92 persons was used to compare the
above-mentioned atlas and bone-specific techniques for determining hand skeleton age in view of these qualitative criteria. Estimate accuracy was studied using Pearson’s correlation coefficients, and weighted kappa coefficients were determined for studying the intra-and interobserver agreement of an estimate result. In the inter-method comparison, a basically good agreement was shown between the skeletal ages and the chronological age of the test persons on the one hand and the skeletal age diagnoses of one or of two examiners on the other. No general advantage of the methodological approach of the bone-specific technique was discernible in the course of comparison; in the female gender, particularly, the RUS2 and RUS3 score of the method of Tanner et al. proved unfavourable. For age estimation practice in criminal proceedings, the atlas methods of Greulich and Pyle and Thiemann et al. are particularly recommendable. Keywords Forensic age estimation . Bone age . Hand skeleton . Comparison of methods . Estimate accuracy . Reproducibility
Introduction S. Schmidt (*) : R. Schulz : H. Pfeiffer : A. Schmeling Institute of Legal Medicine, Münster University Hospital, Röntgenstraße 23, 48149 Münster, Germany e-mail: [email protected] I. Nitz Berlin, Germany S. Ribbecke Dr. Gladitz Statistical Service, Schwedter Straße 225, 10435 Berlin, Germany
Forensic age estimation is a current focus of research interest in the field of forensic medicine. Over the last few years, it has become increasingly important to d
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