BONE-AGE DETERMINATION BASED ON THE STUDY OF THE MEDIAL EXTREMITY OF THE CLAVICLE

The development of the medial clavicular epiphysis and its fusion with the clavicular shaft have been a subject of medical research since th e second decade of this century. Computed tomography provides the imag ing modality of choice in analyzing the maturation process of the ster nal end of the clavicle. In a retrospective study, we analyzed normal development in 380 individuals under the age of 30 years. The appearan ce of an epiphyseal ossification center occurred between ages 11 and 2 2 years. Partial union was found from age 16 until age 26 pears. Compl ete union was first noted at age 22 years and in 100% of the sample at age 27 years. Based on these data, age-related standardized age distr ibutions and 95% reference intervals were calculated. Compared to the experience recorded in the relevant literature, there are several land marks that show no significant change between different ethnic groups and different periods of publication; these are the onset of ossificat ion, the time span of partial union, and the appearance of complete un ion. Despite the relatively long time spans of the maturation stages, bone age estimation based on the study of the development of the media l clavicular epiphysis may be a useful tool in forensic age identifica tion in living individuals, especially if the age of the subject is ab out the end of the second or the beginning of the third decade of life (e.g. in determining the applicability of adult or juvenile penal sys tems). Another possible use is in identifying human remains whose age is estimated at under 30 years.