Applicability of knee MRI in forensic age estimation

Aim: Age estimation in forensic medicine applications is of special importance in terms of law systems and is one of the current research subjects of forensic medicine. In our country, 12-15-18 and 21 years age group are important in terms of legal liability. In cases such as sexual abuse, suspicious birth records, marriage and illegal immigration, forensic authorities usually ask forensic experts to determine the age of the victim or accused. Radiologital methods are mostly used in age determination so non-ionizing methods are preferred in non indication medical applications at recently. Therefore, it was aimed to expand the database in this subject by studying in terms of applicability in forensic age estimation by using MR images which can present non-ionized, non- invasive and detailed images. Material and Method: MR images of patients aged between 10-25 years who were admitted to the outpatient clinics of the Balcalı Hospital of Çukurova University Medical Faculty between January 2012 and April 2018 were retrospectively analyzed according to the staging method described by Dedouit et al. Endocrine disorders, metabolic diseases, systemic diseases, congenital syndroms, bone malignities, steroid therapy, chemotherapy, radiotherapy, fractures of knee joint, surgical fixation, bone marrow edema, etc. were excluded from the study. A total of 489 patients, 292 of whom were male and 197 female, were evaluated for knee MR images. In this study, images obtained from 1.5 T MR, 4 mm section thickness, coronal section fast spin echo proton density weighted sequence were evaluated. Results: Stage 5 (except a 15-year- old and 14-year-old patient) distal femoral epiphysis was seen in both sexes and proximal tibial epiphysis was seen only in males aged 18 years or older. Stage 1 and stage 2 were also observed in all genders for both distal femur and proximal tibial epiphysis under the age of 18. According to the mean age, it was seen that ossification occurred earlier in women than in men. Conclusion: According to the data of our study, MR images are a non-ionizing method that can be used in addition to other radiological methods for determining the age limit of 18 years. Multicentre, comparative and prospective studies are needed by experienced researchers in order to use the routine MRI in age estimates. Key Words: Age Estimation, Magnetic Resonance (MR), Distal Femur, Proximal Tibia