An Evaluation of Age Determination in Forensic Medicine Using Scoring of the Epiphyses at the Knee Joint on Radiographs

Abstract

Objective:Identification plays an important role in forensic medicine practices. Age estimation is also widely used in identification. The aim of this study is to investigate the applicability of age determination method in Türkiye by examining the radiographs of the knee joint and using the epiphyseal scoring based on the degree of epiphyseal closure.Methods:Knee graphs of 676 cases (337 women, 339 men) aged between 10 and 26 years were retrospectively analyzed. Distal femur (DF), proximal tibia (PT), and proximal fibula (PF) epiphyseal lines were evaluated separately in each case. The closure of the epiphyses was studied at 3 stages. DF, PT and PF epiphyses were graded 0, 1, 2 for stage 1, 2 and 3 respectively. These three scores obtained in each case were collected and the score of the epiphyses at the knee joint (SKJ) was obtained.Results:The median age in each of the SKJs increased in both men and women. The difference between the genders was statistically significant according to the median age of 0-5 points (p<0.001). As a result of the receptor operating characteristic curve analysis, the highest accuracy value was found to be 6 points in both genders. In males, the sensitivity was 0.989, the specificity was 0.880, and the overall accuracy was 0.943. In females, these values were found to be 1.000 for sensitivity, 0.648 for specificity, and 0.845 for overall accuracy.Conclusion:The study suggests that knee joint epiphyseal scoring is a simple and practical method with high inter-rater agreement in determining whether a Turkish individual is older than 18 years of age.

Keywords

• forensic medicine
• age determination
• chronological age
• imaging method
• knee joint