Age estimation based on computed tomography analysis of the scapula

Introduction and Objectives: Forensic medical evaluations where radiological methods are combined can be performed in order to specify whether living individuals are in the adult age group or to specify age limits required by different legislative regulations. AGFAD (International and Interdisciplinary Study Group on Forensic Age Diagnostics) suggests the combination of X-ray examination of the left hand with physical examination and dental evaluation carried out with orthopantomogram for the jaw in terms of forensic age estimation. Provided that the development of skeleton of an individual's hand hasn't completed yet, it is suggested that X-ray of clavicles or images taken by computerized tomography should be examined in order to estimate whether the person is 18 or 21 years old. Today, the staging system developed for the aim of age estimation regarding the evaluation of medial clavicle with CT developed by Schmeling and his colleagues has been accepted. The use of staging system has not only been limited with clavicle and studies have been conducted for the purpose of age estimation by using imaging methods on many bones in the skeleton. In our study, obtained data have been examined whether they can be used to estimate age by evaluating ossification points belonging to scapula of thoracic CT images according to the method defined by Schmeling and his colleagues. Material and Method: Thoracic tomographies of 397 cases have been included in the study. 6 ossification centers on the left scapula have been staged and evaluated according to the 5 staged method defined by Schmeling and his colleagues in the tomographies. Intraobserver and interobserver variability of our study has been evaluated by the examination of the same examiner again and a second examiner on 20 cases randomly selected. The data obtained through the study have been statistically analyzed by using IBM SPSS 22.0 statistical program. Findings: 248 (62.5 %) of the 397 cases included in our study are males while 149 (37.5 %) of them are females. The average of age was found to be 19,832 ± 6,4918 for the whole population of the study and 20,167 ± 6,4153 for male cases and 19,276 ± 6,6014 for female cases. A good correlation has been found between ossification stage identified in each ossification center and age in both genders. The obtained correlation has been significant with the value of p<0.001. Discussion and Conclusion: It is seen that all of the cases of stage 1 female are under the age of 18 in ossification points examined in our study and all of the cases of stage 2 female are under the age of 18 in ossification points examined in our study except for inferior angle ossification center. It is seen that all of the stage 1 male and stage 2 male cases are under the age of 18 in ossification points examined in our study except for inferior angle ossification center. No ossification stage has been seen firstly after the age of 18 in male and female cases. As the result of intraobserver and interobserver evaluations, it has been observed that the repeatability of our study is at a good level. We believe that it would be beneficial to examine scapula in previously performed thoracic tomographies due to medical reasons and computerized tomographies of clavicle due to the age estimation in terms of contributing to the forensic age estimation. Keywords: Forensic age estimation, scapula, forensic anthropology, computerized tomography