{"title":"Systematic review on age assessment using Schmeling and Kellinghaus scoring of the medial end of the clavicle by various diagnostic imaging techniques","authors":"Swapnil Akhade , Kiran Akhade , Lina Bhoyar , Pankaj Ghormade , Veena Vaswani","doi":"10.1016/j.jflm.2025.102924","DOIUrl":null,"url":null,"abstract":"<div><div>Estimating age is crucial in legal cases to determine if an individual has reached adulthood, with the medial clavicular epiphysis being the last skeletal part to ossify. X-rays, CT scans, and MRIs are commonly used to assess it, making the evaluation of their accuracy important. This review, adhering to PRISMA guidelines, analyses studies from PubMed, ScienceDirect, and Google Scholar published between 1990 and 2024. Of the 1927 articles initially identified, 32 met the inclusion criteria after screening. Two authors independently conducted the screening process as part of the study selection. A spreadsheet was used for data extraction, and the QUADAS-2 tool was utilized for quality assessment. The study findings indicate that CT scans provide the highest accuracy for age determination in late adolescence and early adulthood due to better imaging resolution. MRI is promising as a non-X-ray alternative, especially when combined with hand/wrist evaluations. Although useful, X-rays have their limitations. Overall, the review suggests that advancing imaging techniques, particularly CT scans, represent the most accurate method for forensic age evaluation from the medial end of the clavicle in late teens and early adolescents, and that establishing population-specific standards is also essential for improving age estimation in forensic and legal contexts.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102924"},"PeriodicalIF":1.2000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of forensic and legal medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1752928X25001258","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, LEGAL","Score":null,"Total":0}
引用次数: 0
Abstract
Estimating age is crucial in legal cases to determine if an individual has reached adulthood, with the medial clavicular epiphysis being the last skeletal part to ossify. X-rays, CT scans, and MRIs are commonly used to assess it, making the evaluation of their accuracy important. This review, adhering to PRISMA guidelines, analyses studies from PubMed, ScienceDirect, and Google Scholar published between 1990 and 2024. Of the 1927 articles initially identified, 32 met the inclusion criteria after screening. Two authors independently conducted the screening process as part of the study selection. A spreadsheet was used for data extraction, and the QUADAS-2 tool was utilized for quality assessment. The study findings indicate that CT scans provide the highest accuracy for age determination in late adolescence and early adulthood due to better imaging resolution. MRI is promising as a non-X-ray alternative, especially when combined with hand/wrist evaluations. Although useful, X-rays have their limitations. Overall, the review suggests that advancing imaging techniques, particularly CT scans, represent the most accurate method for forensic age evaluation from the medial end of the clavicle in late teens and early adolescents, and that establishing population-specific standards is also essential for improving age estimation in forensic and legal contexts.
期刊介绍:
The Journal of Forensic and Legal Medicine publishes topical articles on aspects of forensic and legal medicine. Specifically the Journal supports research that explores the medical principles of care and forensic assessment of individuals, whether adult or child, in contact with the judicial system. It is a fully peer-review hybrid journal with a broad international perspective.
The Journal accepts submissions of original research, review articles, and pertinent case studies, editorials, and commentaries in relevant areas of Forensic and Legal Medicine, Context of Practice, and Education and Training.
The Journal adheres to strict publication ethical guidelines, and actively supports a culture of inclusive and representative publication.