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Skeletal radiographs along with dental examination are frequently used for age estimation in medicolegal cases where documentary evidence pertaining to age is not available. Wrist and hand radiographs are the most common skeletal radiograph considered for age estimation. Other parts imaged are elbow, shoulder, knee, and hip according to suspected age categories. Age estimation by wrist radiographs is usually done by the Tanner-Whitehouse method where the maturity level of each bone is categorized into stages and a final total score is calculated that is then transformed into the bone age. Careful assessment and interpretation at multiple joints are needed to minimize the error and categorize into age-group. In this article, we aimed to summarize a suitable radiographic examination and interpretation for bone age estimation in living children, adolescents, young adults, and adults for medicolegal purposes. [ABSTRACT FROM AUTHOR]

Forensic age assessments are crucial in the evaluation of criminal responsibility and preventing false age claims. Of all the methods available, the Greulich and Pyle (GP) atlas is most commonly used for age estimation purposes. Therefore, the current study sought to analyze the reliability and applicability of the GP standard and, additionally, to determine any possible association between the socioeconomic status (SES), food habits, and estimated skeletal maturity in the North Indian population. The study included 627 (334 males and 293 females) healthy children up to 19 years of age with varying SES and food habits. The skeletal age (SA) was estimated by three different evaluators using the GP atlas. The chronological mean age (CA) and SA were compared in different age cohorts. A paired t-test and a Pearson chi-square test were applied to show the difference between CA and estimated SA and the association of skeletal maturity with SES and food habits. The estimated skeletal age in males was retarded by 0.142 years or 1.72 months (p ≤ 0.05), whereas in females, it was retarded by 0.259 years or 3.12 months (p ≤ 0.05). In males, the GP method has significantly underestimated SA in age cohorts 3–4, 4–5, 6–7, 7–8, 8–9, and 12–13, whereas it overestimated in 10–11 and 18–19 years. However, in females, the SA was significantly underestimated in age groups 10–11, 12–13, and 14–15, respectively. Estimated skeletal maturity had no significant association with SES and food habits. The current study concludes that the GP atlas may not be applicable to North India's population. The observed difference in assessed skeletal maturity may be due to geographical region, genetics, hormonal effects, etc., which require further investigation. Hence, population-specific standards are necessary to determine the bone age of Indian children accurately. [ABSTRACT FROM AUTHOR]

Aim: To compare the dental mineralization stages using Orthopantamogram (OPG) and skeletal maturation stages using Hand wrist radiographs during the pubertal growth period. Material and Methods: The present study was conducted on 60 males and 60 females in Department of Orthodontics, Jaipur Dental College, Jaipur (Rajasthan) India. A total of 120 dental panoramic radiographs and hand-wrist radiographs were obtained and analyzed. The skeletal maturation was assessed using Hand wrist radiograph using the method proposed by Grave and Brown method. Dental maturation stages were analysed from Orthopantamogram (OPG) using the method proposed by Demirjian et al. Results: The results showed differences between the sexes of the sample (P <0.05) and between the skeletal maturation periods. In males, mandibular canine and mandibular second molar were statistically significant (P<0.05) with higher correlation observed in relation to Stage F for onset of pubertal growth, Stage G coincided for peak of the pubertal growth period, Stage H coincided for end of the pubertal growth period In females, mandibular canine and mandibular first premolar were statistically significant (p<0.05)and higher correlation was observed in relation to stage F for the onset of pubertal growth period, Stage G coincided with the peak of the pubertal growth period, Stage H coincided with the end of the pubertal growth period. Conclusion: There is a correlation between dental maturation and Skeletal maturation stages in determining the pubertal growth period. Dental mineralization stages studied from Orthopantamogram(OPG) can be used as a routine diagnostic tool to determine the skeletal maturation of the individual. On comparison of chronological age the females preceded males in all three stages of skeletal maturation by approximately 1.6 years. [ABSTRACT FROM AUTHOR]

Introduction: Bone age estimation is very useful in children undergoing epiphysiodesis or guided growth surgery especially during the years of accelerated growth. It may be noted that no data are available on bone age estimation for Indian children of this age group. Sauvegrain (French) method is a very useful and simple method for bone age assessment during the years of accelerated growth. We decided to check the usefulness and the accuracy of the Sauvegrain method in Indian children. Materials and methods: A team of two pediatric orthopaedic surgeons and a radiologist scored elbow X-rays of 80 healthy children (40 boys and 40 girls), using the Sauvegrain method twice. Interobserver reliability and intraobserver reproducibility of the Sauvegrain scoring were assessed. Results: There was a very strong correlation between all observers in both rounds (r = > 0.8) and an excellent reproducibility by the same observer in both rounds (r = 0.955). Chronological and bone age are considered the same if the difference between them is less than 6 months. With this criterion bone and chronological ages matched in > 37% of boys and girls, similar to the study done in French children. In the nonmatching group, more children had delayed bone age compared to their chronological age. Conclusion: The Sauvegrain method of bone age assessment described for French children was found to be useful in estimating bone age in Indian children. It is especially helpful in the clinical practice for detecting mismatch between the chronological and the radiological age before undertaking guided growth or epiphysiodesis. [ABSTRACT FROM AUTHOR]

• Margin of errors is substantial at times of age determination in living individuals. • Forensic age estimation in commercial sex workers and child laborers carried out. • Biologic age was assessed from skeletal and dental age. • Differences between reported age and assessed biologic age was observed. • Investigators must proceed on with caution taking range of differences between reported and biological age into account. Age estimation in living individuals has attained importance in forensic sciences from legal proceedings and has been a frequent request from concerned authorities to ascertain whether the person in question has reached the age of imputability and legal responsibility. The purpose of age estimation is not just limited to juvenile or sub-adult delinquents but also required in situations like a violation of child rights such as child employment, commercial sexual exploitation involving minor girls. Indian Law strictly forbids any employment of the children under the age of 14 and sexual exploitation of minor girls (<18 years). In this study, we assessed the skeletal and dental ages and correlate to reported chronological ages in a sample of 85 male child labourers and 31 female commercial sex workers. Statistical analysis of the results was performed to verify the similarities or differences between reported and biological age. The results had revealed a statistically significant difference between the reported age, skeletal, dental, and calculated biologic age (p < 0.05). The results indicate the need to establish a more reliable method for determining the biological age in an age-specific population. [ABSTRACT FROM AUTHOR]

Background: Preoperative airway evaluation in children is an important part of routine preanesthetic evaluation before surgery. External airway measurements, viz., thyromental, mentohyoid, and sternomental distances, while being growth dependent, could identify pediatric patients with potentially difficult airways. Objectives: This study was conducted to validate the age- and height-based formulae, derived from a previous study conducted in our institute, to predict thyromental distance, sternomental distance, and mentohyoid distance in relation with the height and age of pediatric patients. Design: Prospective cross-sectional single arm observational study. Setting: Tertiary level university teaching hospital from July 2015 to December 2016. Patients: Children (202) in the age group of 3-15 years with no obvious external airway anomaly scheduled for elective surgery under general anesthesia. Outcomes Measured: The thyromental, mentohyoid, and sternomental distances were measured preoperatively. The same parameters were then calculated based on age- and height-related formulae derived in the earlier study. Results: Bland-Altman analysis of the sample patients showed a mean difference (bias) between measured and calculated values ranging from 0.14 to –0.60 (3 - 13%). Overall agreement in terms of bias were found to be more with height-based equation for mentohyoid distance and thyromental distance and age-based equation for sternomental distance. Conclusion: Our study validates the formulae derived in the earlier study to predict thyromental, mentohyoid, and sternomental distances in children with no obvious external airway anomalies. Further studies are needed to extend the applicability of these formulae in obese children and those with craniofacial anomalies coming for general anesthesia and surgery. [ABSTRACT FROM AUTHOR]

• Calce method is proposed as a tool for age estimation from the acetabulum. • The present study tests the applicability of Calce method in an Indian population. • Morphological features defined by Calce can be easily visualized on CT scans. • Calce method yielded lower accuracy in those aged 40 years and above for the study population. • Lack of applicability of Calce method can be attributed to the broad age ranges it uses. Age estimation is one of the prerequisites of human identification. Age-progressive changes in the pelvis offer useful evidence for forensic age estimation across all age groups. The acetabulum presents as a durable and taphonomic degradation resistant age marker, and, can be employed for analysing age-progressive changes described by Calce. The present study aimed at determining the applicability of the Calce method for age estimation in an Indian population based on a computed tomographic examination of the acetabulum. Additionally, different morphological features defined by Calce were evaluated to identify the feature which contributes most towards the process of age estimation. CT images obtained from clinically undertaken examinations of individuals aged 17 years and above were scrutinized according to the features defined within the Calce method. No statistically significant bilateral or sex differences were observed. An overall accuracy of 76.66% was observed on applying the Calce method to an Indian population, with lower accuracy percentages for individuals aged 40 years and above. The associated overall inaccuracy and bias were found to be 9.45 and 8.88 years, respectively. Within the various features, acetabular groove was found to contribute most towards the overall accuracy, and apex growth the least. Considering this weighted proportion, population specific models should be derived to render greater applicability to the method for age estimation. [ABSTRACT FROM AUTHOR]

Introduction: Determining the age of a person in the absence of documentary evidence of birth is essential for legal and medico-legal purpose. Fishman method of skeletal maturation is widely used for this purpose; however, the reliability of this method for people with all geographic locations is not well-established. Aims and Objectives: In this study, we assessed various stages of carpal and metacarpal bone maturation and tested the reliability of Fishman method of skeletal maturation to estimate the age in South Indian population. We also evaluated the correlation between the chronological age (CA) and predicted age based on the Fishman method of skeletal maturation. Materials and Methods: Digital right hand-wrist radiographs of 330 individuals aged 9-20 years were obtained and the skeletal maturity stage for each subject was determined using Fishman method. The skeletal maturation indicator scores were obtained and analyzed with reference to CA and sex. Data was analyzed using the SPSS software package (version 12, SPSS Inc., Chicago, IL, USA). Results: The study subjects had a tendency toward late maturation with the mean skeletal age (SA) estimated being significantly lowers (P < 0.05) than the mean CA at various skeletal maturity stages. Nevertheless, significant correlation was observed in this study between SA and CA for males (r = 0.82) and females (r = 0.85). Interestingly, female subjects were observed to be advanced in SA compared with males. Conclusion: Fishman method of skeletal maturation can be used as an alternative tool for the assessment of mean age of an individual of unknown CA in South Indian children. [ABSTRACT FROM AUTHOR]

• Sternebral fusion can be used for age estimation. • The present study investigates these changes using CT in an Indian population. • The present study reports that sternebral fusion can estimate age of juveniles. • Sternebral fusion can ascertain if a person has attained the ages of 16 & 18 years. Forensic age estimation is a crucial aspect of the human identification process. Sternebral fusion is one of the skeletal indicators of age that has not been thoroughly researched for the purpose of age estimation. The present study was conducted with the aim of assessing the utility of each of the sternebral fusion in age estimation, and to ascertain if these fusion stages can help in identifying whether an individual has attained the medicolegally significant ages of 16 and 18 years. Thoracic CT images of 148 study participants (74 females, 74 males) were analysed to evaluate the fusion of sternebrae 1–2, sternebrae 2–3, and sternebrae 3–4. The fusion scores for these were found to be statistically significant (P < 0.001) with sternebrae 1–2 fusion showing the highest coefficient of correlation at R = 0.900. Linear regression models were generated using each of the sternebral fusions separately and together for estimation of age. The standard error of estimate for the regression models ranged from 1.51 to 2.86 years. Box and Whisker plots were constructed to see the fusion score wise age distribution of the study population, and it was observed that sternebral fusion has the ability to indicate whether an individual has attained the age of 16 and 18 years. Our study concludes that sternebral fusion can act as an accurate method of forensic age estimation of juveniles and young adults. [ABSTRACT FROM AUTHOR]

• Age estimation is a crucial medicolegal aspect in civil and criminal law. • Medial clavicular epiphyseal (MCE) fusion is a reliable method for age estimation. • Computed Tomography is a newer foray into the science of Forensic age estimation. • CT of the MCE will allow assessment of whether an individual has reached the age of majority. Forensic age estimation is a crucial aspect of the identification process. While epiphyseal fusion of long bones has been studied for age estimation since a long time, over the past few years, the role of medial clavicular epiphyseal fusion in age estimation is being explored. The medial clavicular epiphyseal fusion can be used to estimate age in young adults, and can also determine whether medicolegally significant ages of 16 and 18 years have been attained by an individual. The present study aimed at generating regression models to estimate age by evaluating the medial clavicular epiphyseal fusion in Indian population using Schmeling et al. and Kellinghaus et al. method, and to assess whether an individual's age is over medicolegally significant thresholds of 16 and 18 years. Degree of ossification of the medial clavicular epiphysis was studied in CT images of 350 individuals aged 10.01–35.47 years. Significant statistical correlation (P < 0.001) was observed between the degree of fusion and the chronological age of the participants, with Spearman's correlation (ρ) = 0.918 in females, and ρ = 0.905 in males. Regression models were generated using degree of ossification of medial end of clavicle of 350 individuals (147 females and 203 males) and these models were applied on a test set of 50 individuals (25 females and 25 males). Mean absolute error of 1.50 for females, 1.14 for males, and 1.32 for the total test set was observed when the variance between the chronological ages and estimated ages was calculated. [ABSTRACT FROM AUTHOR]

Abstract: A total 375 Indian children of age 1 day to 19 years were studied (male 194 and female 181). For determining the bone age (skeletal age), wrist and hand radiographs were taken. The skeletal age was determined by blinded review of radiograph using Greulich and Pyle atlas (2nd edition, 1959). If we consider all age group (1–19 years), the Indian boys were retarded in skeletal age by 0.7 years and females by 0.33 years. Male and female children skeletally lag behind the American standard (GP Atlas) in all age groups except 12–13 years age group in which girls are accelerated by 0.22 years. Chronological age and skeletal age difference of more than 1 year is seen between age group 7 years and 12 years in males. Females after second year showed a retardation, which ranged from 0.2 to 0.8 years, up to the age of 19 years. The present study concludes that, Greulich and Pyle atlas is not applicable to the Indian children of both sexes especially in middle and late childhood. [Copyright &y& Elsevier]

The article highlights a study on the radiological bone age assessment by appearance of ossification centres in children in India. The results were compared with Greulich-Pyle (GP) standard and other studies in the country. It was found that female bone maturity is 1 year earlier but maturity in some male bones coincides with age while it is delayed by a year or more in others.