CT of the medial clavicular epiphysis for forensic age estimation – raised arms position recommended

Ruder TD, Kuhnen SC, Zech WD, Klaus JB, Lombardo P, Ith M (2023) Standards of practice in forensic age Estimation with CT of the medial clavicular epiphysis-a systematic review. Int J Legal Med 137(6):1757–1766

Article  PubMed  PubMed Central  Google Scholar 

Schmeling A, Grundmann C, Fuhrmann A, Kaatsch HJ, Knell B, Ramsthaler F, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G (2008) Criteria for age Estimation in living individuals. Int J Legal Med 122(6):457–460

Article  CAS  PubMed  Google Scholar 

Wittschieber D, Ottow C, Vieth V, Küppers M, Schulz R, Hassu J, Bajanowski T, Püschel K, Ramsthaler F, Pfeiffer H, Schmidt S, Schmeling A (2015) Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 129(1):187–193

Article  PubMed  Google Scholar 

Schmeling A, Dettmeyer R, Rudolf E, Vieth V, Geserick G (2016) Forensic age Estimation. Dtsch Arztebl Int 113(4):44–50

PubMed  PubMed Central  Google Scholar 

Schmeling A, Kreitner KF, Heindel W, Vieth V (2019) Bildgebung Zur forensischen altersdiagnostik Bei Jugendlichen und jungen erwachsenen. Radiol Up2date 19(01):63–75

Article  Google Scholar 

Arbeitsgruppe für Forensische Altersdiagnostik (AGFAD) Stellungnahme: Forensische Altersdiagnostik bei unbegleiteten minderjährigen Flüchtlingen [Internet]. 2018 [cited 2024 Aug 31]. Available from: https://www.dgrm.de/institute/deutschland/essen/stellungnahme-forensische-altersdiagnostik-bei-unbegleiteten-minderjaehrigen-fluechtlingen

Hermetet C, Saint-Martin P, Gambier A, Ribier L, Sautenet B, Rérolle C (2018) Forensic age Estimation using computed tomography of the medial clavicular epiphysis: a systematic review. Int J Legal Med 132(5):1415–1425

Article  PubMed  Google Scholar 

Malmqvist E, Furberg E, Sandman L (2018) Ethical aspects of medical age assessment in the asylum process: a Swedish perspective. Int J Legal Med 132(3):815–823

Article  PubMed  Google Scholar 

Tozakidou M, Meister RL, Well L, Petersen KU, Schindera S, Jopp-van Well E, Püschel K, Herrmann J (2021) CT of the medial clavicular epiphysis for forensic age estimation: hands up? Int J Legal Med 135(4):1581–1587

Article  PubMed  PubMed Central  Google Scholar 

Gassenmaier S, Schaefer JF, Nikolaou K, Esser M, Tsiflikas I (2020) Forensic age Estimation in living adolescents with CT imaging of the clavicula-impact of low-dose scanning on readers’ confidence. Eur Radiol 30(12):6645–6652

Article  PubMed  PubMed Central  Google Scholar 

The Royal College of Radiologists IR(ME)R: Implications for clinical practice in diagnostic imaging, interventional radiology and diagnostic nuclear medicine. [Internet]. 2018 [cited 2024 Aug 31]. Available from: https://www.rcr.ac.uk/our-services/all-our-publications/

Mühler M, Schulz R, Schmidt S, Schmeling A, Reisinger W (2006) The influence of slice thickness on assessment of clavicle ossification in forensic age diagnostics. Int J Legal Med 120(1):15–17

Article  PubMed  Google Scholar 

Kreitner KF, Schweden FJ, Riepert T, Nafe B, Thelen M (1998) Bone age determination based on the study of the medial extremity of the clavicle. Eur Radiol 8(7):1116–1122

Article  CAS  PubMed  Google Scholar 

Ramsthaler F, Proschek P, Betz W, Verhoff MA (2009) How reliable are the risk estimates for X-ray examinations in forensic age estimations? A safety update. Int J Legal Med 123(3):199–204

Article  CAS  PubMed  Google Scholar 

Meier N, Schmeling A, Loose R, Vieth V (2015) Altersdiagnostik und strahlenexposition. Rechtsmedizin 25(1):30–33

Article  Google Scholar 

Scharte P, Vieth V, Schulz R, Ramsthaler F, Püschel K, Bajanowski T, Pfeiffer H, Schmeling A, Schmidt S, Wittschieber D (2017) Comparison of imaging planes during CT-based evaluation of clavicular ossification: a multi-center study. Int J Legal Med 131(5):1391–1397

Article  PubMed  Google Scholar 

Deak PD, Smal Y, Kalender WA (2010) Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 257(1):158–166

Article  PubMed  Google Scholar 

Huda W (2010) Review of radiologic physics. Lippincott Williams & Wilkins, p 272

Cohen J (2013) Statistical power analysis for the behavioral sciences, 2nd edn. Routledge, New York, p 567

Book  Google Scholar 

Allen M, Poggiali D, Whitaker K, Marshall TR, van Langen J, Kievit RA (2019) Raincloud plots: a multi-platform tool for robust data visualization. Wellcome Open Res 4:63

Article  PubMed  Google Scholar 

Brink M, de Lange F, Oostveen LJ, Dekker HM, Kool DR, Deunk J, Edwards MJR, van Kuijk C, Kamman RL, Blickman JG (2008) Arm Raising at exposure-controlled multidetector trauma CT of thoracoabdominal region: higher image quality, lower radiation dose. Radiology 249(2):661–670

Article  PubMed  Google Scholar 

Euler A, Szücs-Farkas Z, Schindera S (2014) Möglichkeiten der strahlenreduktion Bei der CT des Körperstamms. Radiol Up2date 14(02):163–176

Article  Google Scholar 

Tozakidou M, Yang SR, Kovacs BK, Szucs-Farkas Z, Studler U, Schindera S, Hirschmann A (2019) Dose-optimized computed tomography of the cervical spine in patients with shoulder pull-down: is image quality comparable with a standard dose protocol in an emergency setting? Eur J Radiol 120(108655):108655

Article  PubMed  Google Scholar 

Bayer J, Pache G, Strohm PC, Zwingmann J, Blanke P, Baumann T, Südkamp NP, Hammer T (2011) Influence of arm positioning on radiation dose for whole body computed tomography in trauma patients. J Trauma 70(4):900–905

PubMed  Google Scholar 

Karlo C, Gnannt R, Frauenfelder T, Leschka S, Brüesch M, Wanner GA, Alkadhi H (2011) Whole-body CT in polytrauma patients: effect of arm positioning on thoracic and abdominal image quality. Emerg Radiol 18(4):285–293

Article  PubMed  Google Scholar 

Bundesamt für Gesundheit (BAG) Diagnostische Referenzwerte im Strahlenschutz [Internet]. [cited 2024 Aug 31]. Available from: https://www.bag.admin.ch/bag/de/home/gesetze-und-bewilligungen/gesuche-bewilligungen/bewilligungen-aufsicht-im-strahlenschutz/informationen-fuer-medizinische-betriebe/diagnostische-referenzwerte-im-strahlenschutz.html

Bundesamt für Gesundheit (BAG). Strahlenschutz und Überwachung der Radioaktivität in der Schweiz– Ergebnisse 2023 [Internet]. Bern, Switzerland: Bundesamt für Gesundheit (BAG) (2024) Report No.: 978-3-033-07889–5. Available from: https://www.bag.admin.ch

Radiological Society of North America (RSNA) Radiation Dose [Internet]. 2025 [cited 2025 Mar 19]. Available from: https://www.radiologyinfo.org/en/info/safety-xray

Pattamapaspong N, Madla C, Mekjaidee K, Namwongprom S (2015) Age Estimation of a Thai population based on maturation of the medial clavicular epiphysis using computed tomography. Forensic Sci Int 246:123e1–123e5

Article  Google Scholar 

Schulz R, Mühler M, Mutze S, Schmidt S, Reisinger W, Schmeling A (2005) Studies on the time frame for ossification of the medial epiphysis of the clavicle as revealed by CT scans. Int J Legal Med 119(3):142–145

Article  PubMed  Google Scholar 

Schulze D, Rother U, Fuhrmann A, Richel S, Faulmann G, Heiland M (2006) Correlation of age and ossification of the medial clavicular epiphysis using computed tomography. Forensic Sci Int 158(2–3):184–189

Article  PubMed  Google Scholar 

Kellinghaus M, Schulz R, Vieth V, Schmidt S, Pfeiffer H, Schmeling A (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124(4):321–325

Article  PubMed  Google Scholar 

Kellinghaus M, Schulz R, Vieth V, Schmidt S, Schmeling A (2010) Forensic age Estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med 124(2):149–154

Article  PubMed  Google Scholar 

Franklin D, Flavel A (2015) CT evaluation of timing for ossification of the medial clavicular epiphysis in a contemporary Western Australian population. Int J Legal Med 129(3):583–594

Article  PubMed  Google Scholar 

Mehnert S, Berger N, Flach PM, Thali MJ, Ampanozi G, Franckenberg S (2023) How low can we go? CT dose reduction in the assessment of the medial clavicular epiphysis in forensic age estimation: a prospective postmortem CT study. Acta Radiol 64(6):2126–2131

Article  PubMed  Google Scholar 

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