Schmeling Andreas, Schulz Ronald, Reisinger Walter, Mühler Matthias, Wernecke Klaus-Dieter, Geserick Gunther
Institut für Rechtsmedizin, Universitätsklinikum Charité der Humboldt-Universität zu Berlin, Hannoversche Strasse 6, 10015 Berlin, Germany.
Int J Legal Med. 2004 Feb;118(1):5-8. doi: 10.1007/s00414-003-0404-5. Epub 2003 Oct 8.
Radiological assessment of the degree of ossification of the medial clavicular epiphyseal cartilage plays a vital part in forensic age diagnosis of living adolescents and young adults. A total of 873 plain chest radiographs requested by the staff medical officer for members of staff aged 16-30 at the University Hospital Charité were evaluated retrospectively. Of these X-rays 699 permitted an assessment of ossification of at least 1 side of the clavicle. In addition to the customary stages (1: non-ossified epiphysis, 2: discernible ossification centre, 3: partial fusion, 4: total fusion) a stage 5 was also defined, characterised by the disappearance of the epiphyseal scar following total fusion. The earliest age at which stage 3 was detected in either gender was 16 years. Stage 4 was first observed in women at 20 years and in men at 21 years. In both genders, the earliest observation of stage 5 was at 26 years. It was concluded that plain chest radiographs can essentially be used to assess clavicular ossification. In practice, if overlap in posterior-anterior views impedes evaluation, a lateral view should also be taken to facilitate age estimation. In forensic practice the reference values of the present paper should be applied.
锁骨内侧骨骺软骨骨化程度的放射学评估在青少年和青年活体的法医年龄诊断中起着至关重要的作用。对柏林夏里特大学医院工作人员医疗官为16至30岁工作人员所要求拍摄的873张胸部平片进行了回顾性评估。在这些X光片中，699张允许对至少一侧锁骨的骨化情况进行评估。除了常规阶段（1：骨骺未骨化，2：可辨认的骨化中心，3：部分融合，4：完全融合）外，还定义了一个5期，其特征是完全融合后骨骺瘢痕消失。在任何性别中检测到3期的最早年龄为16岁。4期在女性中首次观察到的年龄为20岁，在男性中为21岁。在两种性别中，最早观察到5期的年龄均为26岁。结论是胸部平片基本上可用于评估锁骨骨化情况。在实际操作中，如果前后位重叠妨碍评估，也应拍摄侧位片以方便年龄估计。在法医实践中应应用本文的参考值。
