International Journal of Legal Medicine最新文献

{"title":"Improving reliability of permanent tooth staging for dental age estimation using the crown-root ratio method.","authors":"Amir H Abdul Rahim, Janet A Davies, Helen M Liversidge","doi":"10.1007/s00414-026-03861-7","DOIUrl":"10.1007/s00414-026-03861-7","url":null,"abstract":"<p><strong>Objective: </strong>Root staging for dental age estimation is subjective when no standard reference is available. This study developed a quantitative approach for Moorrees root stages (R1/4, R1/2, R3/4 and Rc) using crown-root ratio (CRR) measurements and stage-specific bounds.</p><p><strong>Materials and methods: </strong>The development phase included 269 Malaysian subjects (145 males, 124 females) aged 16-25 years. A total of 1,502 mature permanent mandibular left teeth (I1-M3) were measured on panoramic radiographs using ImageJ software to determine mean CRR values for mature roots (Rc), the fraction stages and stage-specific bounds, where [Formula: see text], [Formula: see text], and lower bound=succeeding stage CRR + 0.01. Sex differences were analysed using independent t-tests. Validation used 161 additional radiographs (78 males, 83 females) aged 3-24 years, with 774 developing and mature permanent mandibular left teeth measured and independently staged according to Moorrees' method. Measured CRR values were compared with stage-specific bounds and considered accurate when within the expected range. Accuracy was calculated as: [Formula: see text].</p><p><strong>Results: </strong>Mean CRR values ranged from 0.50 to 0.82, with M3 showing the greatest variability. Significant sex differences were observed for C, P1, M1 and M2 (p < 0.05). Overall staging accuracy was 89.9% (84.6%-95.7%) and declined progressively from R1/4 to Rc. M3 (95.7%) and C (91.3%) showed the highest accuracy, whereas I1 (85.7%) and M1 (88.0%) showed the lowest.</p><p><strong>Conclusion: </strong>The CRR method provides an objective approach for defining Moorrees root stages and improving staging consistency.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"3993-4001"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined lethal intoxication involving 2-methyl-2-butanol.","authors":"Martin Dokter, Paul Hagen, Julia Wudtke, Ricarda Kegler, Britta Bockholdt, Giovanni Talarico","doi":"10.1007/s00414-026-03900-3","DOIUrl":"10.1007/s00414-026-03900-3","url":null,"abstract":"<p><p>The aim was to investigate and clarify the cause of death of a 26-year-old male found dead in his apartment. It was known that the individual used drugs of abuse. In the apartment, the police found amongst others a \"brown powder\" and a glass bottle labeled with \"2-methyl-2-butanol\" (2m2b). Autopsy and chemical analyses were performed. The autopsy revealed unspecific morphological signs of an intoxication (cerebral swelling and cyanosis, pulmonary edema, full urine bladder). Headspace gas chromatography with flame ionization detection (HS-GC-FID) was used to determine 2m2b and ethanol. Concentrations of 245 mg/L and 225 mg/L 2m2b could be detected in the femoral vein blood specimen and urine, respectively. Ethanol was detected below the level of quantification (0,2 g/L) in both matrices. The detected blood concentration of 2m2b was more than twice as high as the 2m2b concentration described as comatose in a previous published case report. However, in the presented case further analysis revealed toxic concentrations of methamphetamine and venlafaxine and also identified a previous intake of heroin and diazepam. Thus, a combined drug intoxication was assumed as cause of death. Little is known about the abuse of 2m2b as an alternative to ethanol. Since 2m2b is widely available, cheap, more potent than ethanol, while lacking its hangover effects and is likely not detected by routine HS-GC-FID methods for the detection of blood ethanol concentrations, it may be of forensic relevance.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"4457-4462"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cracking the code of heatstroke: new insights into diagnosis and pathological mechanisms.","authors":"Hongli Xiong, Cunhao Bian, Yue Zhao, Yu Sen Wang, Bi Wei, Hao Xiao, Li Zhang, Shisheng Zhu, Jianbo Li","doi":"10.1007/s00414-026-03910-1","DOIUrl":"10.1007/s00414-026-03910-1","url":null,"abstract":"<p><p>As global temperatures continue to rise, the incidence and mortality rates of heatstroke (HS) have significantly increased. However, the current forensic diagnostic standards lack clear pathological criteria for deaths caused by HS, and the mechanisms of multi-organ damage induced by HS are not yet fully understood. In this study, a rat model of HS-induced death was established under conditions of 39 ± 0.5 °C and 60% ± 5% humidity. Through histopathological observation, attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) spectroscopy, and machine learning algorithms, the most severely damaged organs in HS were identified, including the hypothalamus, hippocampus, liver, and spleen. Next, we performed transcriptomic (UID mRNA-seq) and proteomic (Data-Independent Acquisition technology, DIA) analyses on the key target organ-the hypothalamus. Transcriptomic analysis revealed 447 differentially expressed genes (DEGs), with 197 genes upregulated and 250 genes downregulated. Proteomic analysis identified 692 differentially expressed proteins (DEPs), with 241 proteins upregulated and 451 proteins downregulated. Integrated multi-omics analysis indicated significant enrichment of pathways such as endoplasmic reticulum protein processing, MAPK signaling, and apoptosis following HS. Further, three key genes/proteins (Hspb1, Dnaja1, Jun) were identified and their expression changes in the hypothalamus of HS rats were validated using quantitative real-time PCR (qRT-PCR), Western blot, and immunohistochemistry. Overall, this study provides new insights into the diagnosis and mechanisms of HS and offers scientific evidence for the clinical treatment of HS.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"3733-3746"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico-legal aspects of fatal ricin poisoning: a systematic review of clinical manifestations, toxicological findings and autopsy results.","authors":"Isabella Aquila, Matteo Antonio Sacco","doi":"10.1007/s00414-026-03949-0","DOIUrl":"10.1007/s00414-026-03949-0","url":null,"abstract":"<p><p>Ricin, a potent protein toxin derived from Ricinus communis, is considered one of the most significant threats in cases of bioterrorism, homicide, suicide, and accidental acute poisoning. However, its clinical and pathological features in fatal cases have not been systematically summarized. This systematic review aimed to summarize the current evidence regarding the clinical manifestations, toxicological biomarkers, autopsy findings, and medico-legal aspects of fatal ricin poisoning. A comprehensive literature search was conducted in accordance with PRISMA guidelines. Original studies, case reports, and case series reporting detailed clinical, toxicological, or autopsy data following fatal or near-fatal human exposure to ricin were included in the review. The available evidence suggests a relatively consistent clinical course, characterized by rapid progression from mild, nonspecific gastrointestinal symptoms to hypovolemic shock, multi-organ failure, and refractory cardiovascular collapse. Ricinine was consistently detected in blood, urine, and postmortem tissues, supporting its role as a reliable biomarker of ricin exposure, although current evidence is insufficient to establish definitive correlations with poisoning severity or toxicokinetics. Reported autopsy findings commonly included hemolysis, hemorrhagic necrosis of the gastrointestinal tract, hepatic injury, renal tubular necrosis, and evidence supporting the presence of a capillary leak syndrome. Several specific medico-legal challenges emerged from the reviewed literature, including the need for the development of novel analytical methods with improved detection limits and quantification capabilities for ricinine, the interpretation of postmortem redistribution phenomena, the distinction between lethal and non-lethal exposures, and the differential diagnosis with other septic shock-like syndromes. Overall, the available evidence suggests a relatively consistent clinicopathological pattern associated with fatal ricin poisoning that can be corroborated through ricinine detection, while emphasizing the importance of early toxicological investigations, particularly when no history of exposure is available. These findings provide a concise and integrated body of evidence to support clinical management, inform forensic investigations, and enhance public health preparedness, while highlighting the need for standardized postmortem sampling protocols and further research into the toxicodynamics of ricin in humans.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"3597-3609"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visible injury patterns in relation to reported sexual acts after sexual assault: a retrospective cohort study.","authors":"Alice Buzzelli, Julia Babigian, Valentina Bugelli, Lars Oesterhelweg, Alberto Amadasi","doi":"10.1007/s00414-026-03941-8","DOIUrl":"10.1007/s00414-026-03941-8","url":null,"abstract":"<p><p>Sexual assault may result in visible anogenital and extragenital injuries, but the absence of such findings remains a major challenge in forensic interpretation. This retrospective forensic outpatient study analyzed 306 adults examined after reported sexual assault at the Violence Protection Ambulatory of Charité - Universitätsmedizin Berlin between January 2016 and December 2023. Demographic, assault-related, and injury-related variables were extracted from finalized forensic examination reports. The primary aim was to assess the frequency of predefined anatomically or regionally corresponding visible injuries in relation to reported oral, vaginal, and anal sexual acts. Extragenital injuries were documented in 216/306 cases (70.6%), whereas anogenital injuries were documented in 62/306 cases (20.3%). Among 256 individuals reporting at least one oral, vaginal, or anal sexual act, predefined corresponding visible injuries were present in 72 cases (28.1%, 95% CI 23.0-33.9) and absent in 184 cases (71.9%). Corresponding anogenital injuries were uncommon after reported vaginal acts and were not significantly associated with reported vaginal acts or penile-vaginal penetration. Reported anal sexual violence and oral sexual violence were significantly associated with anal and facial injuries, respectively; however, corresponding injuries were still absent in most cases. In multivariable logistic regression, the number of reported sexual acts was the only variable independently associated with absence of corresponding visible injury. These findings demonstrate the limited sensitivity of visible injury documentation after reported sexual assault. The presence of a corresponding injury may support the assessment of consistency with the reported history, but the absence of visible injury must not be interpreted as excluding the reported assault.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"4265-4276"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical review of autopsy findings in cases of suicidal hanging and the effect of a layered neck dissection.","authors":"James Robert Lyness, Guy Rutty, Jane Rutty, Michael Biggs","doi":"10.1007/s00414-026-03917-8","DOIUrl":"10.1007/s00414-026-03917-8","url":null,"abstract":"<p><p>Suicidal hanging is a common case type referred to death investigation services throughout the world. It is associated with a large number of autopsy findings, but the presentation can vary significantly between cases, based on a multitude of factors related to the decedent, ligature and degree of suspension. There is also considerable variation in the reported incidence of autopsy findings within the published literature, some of which may be explained by different anthropometric characteristics of the included cases. However, study design and the thoroughness of the autopsy examination undertaken also undoubtedly influence results. This study therefore aimed to retrospectively review a series of autopsy reports from cases of suicidal hanging to assess not only the incidence of common findings identified during Coronial autopsies recently undertaken within a single region of the United Kingdom (UK), but also how the quality or thoroughness of the examination influenced their rate of detection. The results demonstrated considerable variation in the detection rates of common autopsy findings between individual consultant forensic pathologists and that the detection of neck muscle bruising (p = < 0.001), hyoid bone fractures (p = < 0.001) and thyroid cartilage fractures (p = 0.009) was greater when a layered neck dissection was undertaken. As a secondary objective, the range, incidence and impact of any natural disease and trauma additional to the ligature mark identified during the autopsy were assessed. Despite the array of natural disease and trauma recorded, none was considered critical to providing the underlying primary medical cause of death to the Coroner.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"3775-3785"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated MRI-based framework combining deep learning localization and machine learning classification for pubertal olecranon bone age assessment.","authors":"Yuting Luo, Xiaofei Zhang, Shinong Pan, Fuyao Yu","doi":"10.1007/s00414-026-03934-7","DOIUrl":"10.1007/s00414-026-03934-7","url":null,"abstract":"<p><strong>Objectives: </strong>This study developed a magnetic resonance imaging (MRI)-based artificial intelligence (AI) framework for ordered pubertal olecranon bone age (BA) staging and evaluated internal performance and preliminary cross-centre transportability.</p><p><strong>Materials and methods: </strong>This retrospective two-centre study included a development cohort of 197 elbow MRI examinations from Shengjing Hospital of China Medical University and an independent external-validation cohort of 72 elbow MRI examinations from Handan Central Hospital. The development cohort comprised 77 girls aged 9.5-13 years and 120 boys aged 11.5-15 years, whereas the external-validation cohort comprised 30 girls aged 9.5-13 years and 42 boys aged 11.5-15 years. Manually delineated olecranon ROIs were used for preprocessing and YOLO-v8m detector training. Localized images were processed using ResNet-50 feature extraction, Fisher score-based feature selection, and an NN classifier. The locked development-centre pipeline was applied unchanged to the external-validation cohort without retraining, repeated feature selection, hyperparameter tuning, or checkpoint selection based on external data.</p><p><strong>Results: </strong>Automated localization achieved a mean average precision of 1.0. The final NN classifier reached internal-validation accuracies of 94.12% in girls and 93.75% in boys, with stage-mapped mean absolute error (MAE)/root mean square error (RMSE) values of 0.029/0.121 and 0.062/0.250 years, respectively. In the external cohort, girls achieved an accuracy of 86.67%, MAE of 0.233 years, and RMSE of 0.658 years, weighted kappa of 0.922, and ICC of 0.969, whereas boys achieved an accuracy of 90.48%, MAE of 0.095 years, RMSE of 0.309 years, unweighted kappa of 0.890, weighted kappa of 0.963, and ICC of 0.991.</p><p><strong>Conclusion: </strong>The MRI-based framework provided stage-consistent internal performance and preliminary evidence of cross-centre transportability within the studied pubertal age window. It should be interpreted as a supplementary maturity marker rather than a stand-alone forensic age-estimation tool.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2500109735), retrospectively registered on September 24, 2025.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"3901-3917"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decomposition dynamics across sequential environments: subaerial and freshwater aquatic transitions.","authors":"Alexandra Helen Lindsay, Lawrence Hill, Craig Adam Keyes","doi":"10.1007/s00414-026-03887-x","DOIUrl":"10.1007/s00414-026-03887-x","url":null,"abstract":"<p><p>Decomposition studies are pivotal for forensic science, offering insights into postmortem events. While decomposition dynamics in static environments are well-documented, transitions between subaerial and aquatic settings remain underexplored, particularly in diverse ecological regions. Decomposition rates were investigated in juvenile piglets subjected to subaerial-to-freshwater aquatic and freshwater aquatic-to-subaerial transitions. Twelve piglets were used in total: five in each experimental group and two controls, each exposed exclusively to either subaerial or aquatic conditions. Decomposition progression was quantified using Adjusted Total Body Scores and Total Aquatic Decomposition Scores, which were standardized for cross-environment comparison. Accumulated Degree Days were calculated to account for thermal input. The subaerial-to-aquatic transitions exhibited delayed decomposition initially, followed by rapid tissue breakdown post-submersion, often leading to near-complete skeletonization. In contrast, aquatic-to-subaerial transitions displayed rapid decomposition during submersion, followed by reduced activity and partial or complete mummification after environmental change. These shifts were reflected in scoring results but also revealed morphological changes not accounted for in current scoring systems. Transitions between environments significantly alter decomposition rates and patterns. Existing scoring systems proved limited in accounting for these shifts, particularly in cases of mummification. Findings from this study highlight the need for a novel scoring framework tailored to fluctuating environments and calls for further research into decomposition morphology specific to environmental transitions.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"3677-3688"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A swab and wetting agent combination investigation for enhanced touch DNA recovery: A step towards standardisation.","authors":"Hilary Arsenault, Roland A H van Oorschot, Duncan Taylor, Adrian Linacre, Mariya Goray","doi":"10.1007/s00414-026-03907-w","DOIUrl":"10.1007/s00414-026-03907-w","url":null,"abstract":"<p><p>Swabs are commonly used in forensic contexts to recover biological material from surfaces. Previous investigations have shown that there is no single best swab and wetting agent combination for DNA recovery. Touch DNA is often present in low quality and quantity, and the recovery and processing methods used during casework can result in DNA loss, therefore even small improvements in recovery could influence successful detection. Therefore, a DNA recovery method tailored for a touch DNA workflow is fundamental to effective forensic casework. In this study, combinations of five swabs (viscose, cotton, nylon, foam and polyester) and three wetting agents (water, 100% isopropanol (IPA) and 2% sodium dodecyl sulphate (SDS)) were used to collect samples of synthetically and naturally derived touch DNA from a polypropylene surface. Surfaces were swabbed using a single systematic swabbing method and extracted using the DNA IQ™ system. Interactions between the swabs and wetting agents had the greatest effect on DNA recovery, and polyester swabs moistened with SDS were among the combinations with the highest DNA yield under these experimental conditions. The worst-performing swabs differed by DNA type sampled. Polyester, viscose and cotton swabs moistened with water were amongst the combinations yielding the lowest DNA recovery for the synthetic touch deposits, whereas foam and nylon swabs moistened with IPA had the lowest yield for natural touch deposits. This research aims to contribute towards the development of a standardised touch DNA recovery method applicable to the sampling of polypropylene surfaces and other relevant touch DNA collection related objectives, such as investigations into DNA transfer and shedder testing.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"4135-4156"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forensic age estimation using knee MRI: application of the Vieth staging system in a French population.","authors":"Oguzhan Ekizoglu, Quentin Rebillard, Sophie Colomb, Eric Baccino, Maxime Pastor, Catherine Cyteval, Marie-Christine Sordino, Laurent Martrille","doi":"10.1007/s00414-026-03901-2","DOIUrl":"10.1007/s00414-026-03901-2","url":null,"abstract":"<p><p>Forensic age assessment is a critical process in determining an individual's legal status, particularly in the evaluation of the 18-year threshold, where reliable methods are essential. In this study, epiphyseal maturation of the knee was analyzed in a French population using magnetic resonance imaging (MRI) based on the Vieth staging system. A total of 512 knee MRI examinations (280 males, 232 females; age range 9-30 years) were retrospectively evaluated. The distal femoral and proximal tibial epiphyses were assessed using the six-stage Vieth classification on T1-weighted and fat-suppressed proton density (PD-FSE) sequences. A strong association between chronological age and ossification stage was observed (r ≈ 0.88; p < 0.001). Intraobserver agreement was almost perfect (κ = 0.99), and interobserver agreement was very good (κ = 0.81-0.87). No significant sex-related differences were identified across stages. The minimum age for complete fusion (stage 6) was 21.13 years in males and 20.74 years in females for the distal femur, and 19.92 and 17.69 years for the proximal tibia, respectively. These findings demonstrate that knee MRI using the Vieth system represents a reliable and reproducible method across different populations and observers. Further validation through studies involving diverse populations and varied MRI protocols is expected to enhance its standardization and strengthen its role in forensic decision-making.</p>","PeriodicalId":14071,"journal":{"name":"International Journal of Legal Medicine","volume":" ","pages":"4157-4165"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}