Evaluation of their use in gender and age determination by examing sacrum, coccyx and proximal femur through computerized tomography images in Aydın province

In forensic medicine practice, examination starts with identification, whether in the antemortem or postmortem period. Identification performed medically and forensically is challenging for the physician, especially in severely deteriorated or decayed corpses. Morphological and metric studies are performed on various bones for gender and age determination in corpses where only bone remains remain. The purpose of this study is to estimate gender and age using anthropometric measurements obtained from Computerized Tomography images of sacrum, coccyx and proximal femur and to contribute to this subject. The study was conducted analytically and cross-sectionally by evaluating the abdominopelvic CT images of 100 male and 100 female patients who applied to Aydın Adnan Menderes University Hospital for any reason between January 2023 and July 2024. The cases were divided into 5 subgroups at ten-year intervals. A total of 13 measurements were made on the images, 10 in the sacrococcygeal (ASL, PSL, ASCL, PSCL, APD, MTD, PERIMETER, AREA, SD, MBA) and 3 in the right proximal femur to ensure standardization (NALF, NHF and BNLF). Descriptive statistics chi-square, student-t and Mann-Whitney U tests were used in the analysis of the data. Results: In the population studied, the mean ASL, PSL, ASCL, PSCL, APD, MTD, PERIMETER, AREA, SD, MBA, NALF, NHF and BNLF values were found to be significant between genders (p<0.05) and it was determined that these values could be used in gender determination. APD, MTD, PERIMETER, AREA and SD values showed a significant increase for age in the total population (p<0.05), while there was no significant change with age in other parameters (ASL, PSL, ASCL, PSCL, MBA, NALF, NHF and BNLF) (p>0.05). In this study, the potential use of sacro-coccygeal and right proximal femur measurements in determining gender and age groups was investigated. In line with the research findings, it was concluded that these measurements could be used in gender and age determination in severely decomposed, fragmented, completely burnt or skeletonized human remains. In addition, it is recommended to use machine learning methods and artificial intelligence applications on a large sample in order to reduce measurement differences that may arise between experts. It has been evaluated that this approach can make significant contributions to identification processes as well as other areas of medicine. Keywords: Forensic Medicine, Sacrum, Coccyx, Proximal Femur, Sex Determination, Age Determination