Wittschieber Daniel, Ottow Christian, Schulz Ronald, Püschel Klaus, Bajanowski Thomas, Ramsthaler Frank, Pfeiffer Heidi, Vieth Volker, Schmidt Sven, Schmeling Andreas
Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
Institute of Clinical Radiology, University Hospital Münster, Münster, Germany.
Int J Legal Med. 2016 Jan;130(1):213-9. doi: 10.1007/s00414-015-1285-0. Epub 2015 Oct 30.
The radiological investigation of the ossification stage of the medial clavicular epiphysis represents the crucial tool for assessing whether a living individual has completed the age of 18 years. However, exposure to radiation cannot always be accepted due to legal reasons and radiation-free methods still lack reference data or are not available. Therefore, this study examines the role of pre-existing radiographic material of the clavicles, making it necessary to prospectively validate the established five-stage classification system for evaluating the clavicular ossification process as well as to enlarge the so far very limited pool of available reference data. Accordingly, standard posterior-anterior projection radiographs of 836 sternoclavicular joints prospectively obtained during 418 forensic autopsies (age range 15-30 years) were analyzed. Stage III was first found at ages 16 and 15 (males/females), stage IV at ages 22 and 21 (males/females), and stage V at age 26 in both sexes. The presented results principally corroborate the previous reference data from 2004, suggesting reliability of the five-stage classification system. In conclusion, chest radiographs may still be useful for forensic age diagnostics in living individuals but only in certain cases. In age estimations which can be planned in advance, projection radiography of the clavicle must still be considered obsolete.
锁骨内侧骨骺骨化阶段的放射学检查是评估活体个体是否已满18岁的关键工具。然而，由于法律原因，辐射暴露并非总能被接受，且无辐射方法仍缺乏参考数据或尚未可用。因此，本研究探讨了锁骨既往放射影像资料的作用，有必要对既定的用于评估锁骨骨化过程的五阶段分类系统进行前瞻性验证，并扩大目前非常有限的可用参考数据集。相应地，对在418例法医尸检（年龄范围15 - 30岁）期间前瞻性获取的836个胸锁关节的标准后前位投照X线片进行了分析。III期在16岁和15岁（男性/女性）首次出现，IV期在22岁和21岁（男性/女性）出现，V期在两性均为26岁出现。呈现的结果主要证实了2004年以前的参考数据，表明五阶段分类系统具有可靠性。总之，胸部X线片在活体个体的法医年龄诊断中可能仍然有用，但仅在某些情况下。在可以提前计划的年龄估计中，锁骨投照X线摄影仍被认为过时。
