Estimating forensic age via magnetic resonance imaging of the distal radial epiphysis

  • Ali Er
  • Mustafa Bozdag
  • Can Doruk Basa
  • Ismail Eralp Kacmaz
  • Oguzhan EkizogluEmail author
Original Article


Magnetic resonance imaging is currently being studied extensively, but it is still far from being the frequently recommended radiological method for age estimation. In this study, we used magnetic resonance imaging (MRI) of distal radius ossification to obtain data for age estimation. Wrist MRI scans from 338 individuals, aged 10–29 years, were examined retrospectively using the staging system of Schmidt et al. and the extension of the stages as described by Timme et al. The results revealed that the minimum ages for stage 4a ossification were 16.0 years in women and 17.7 years in men, whereas those for stage 4b ossification were 16.6 and 18.2 years in women and men, respectively. Stage 5 was not detected in any patient. These results were comparable with those of a previous study using the same methodology with distal radial epiphysis ossification. Our finding regarding stage 4b ossification may provide valuable information on legally important age thresholds relevant to the use of MRI in evaluating the distal radial epiphysis in males. Further research needs to be conducted with large series in different populations to evaluate the triple banding at the distal radial epiphysis.


Age estimation Distal radial epiphysis MRI 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    UNHCR Asylum Trends (2014) Levels and trends in industrialized countries.
  2. 2.
    Separated Children in Europe Programme—Thematic Group on Age Assessment (2011) Review of current laws, policies and practices relating to age assessment in sixteen European Countries. practice_in_Europe_2011_pdf.pdf. CrossRefGoogle Scholar
  3. 3.
    Dünkel F, Grzywa J, Horsfield P, Pruin I (2010) Juvenile justice systems in Europe. Forum, GodesbergGoogle Scholar
  4. 4.
    Schmeling A, Grundmann C, Fuhrmann A, Kaatsch HJ, Knell B, Ramsthaler F, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G (2008) Criteria for age estimation in living individuals. Int J Legal Med 122:457–460CrossRefGoogle Scholar
  5. 5.
    Schmidt S, Schiborr M, Pfeiffer H, Schmeling A, Schulz R (2013) Age dependence of epiphyseal ossification of the distal radius in ultrasound diagnostics. Int J Legal Med 127:831–838. CrossRefPubMedGoogle Scholar
  6. 6.
    Schmidt S, Schiborr M, Pfeiffer H, Schmeling A, Schulz R (2013) Sonographic examination of the apophysis of the iliac crest for forensic age estimation in living persons. Sci Justice 53:395–401. CrossRefPubMedGoogle Scholar
  7. 7.
    Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A (2013) Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals. Forensic Sci Med Pathol 9:351–357. CrossRefPubMedGoogle Scholar
  8. 8.
    Schmidt S, Mühler M, Schmeling A, Reisinger W, Schulz R (2007) Magnetic resonance imaging of the clavicular ossification. Int J Legal Med 121:321–324. CrossRefPubMedGoogle Scholar
  9. 9.
    Vieth V, Schulz R, Brinkmeier P, Dvorak J, Schmeling A (2014) Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle. Forensic Sci Int 241:118–122. CrossRefPubMedGoogle Scholar
  10. 10.
    Ekizoglu O, Hocaoglu E, Can IO, Inci E, Aksoy S, Bilgili MG (2015) Magnetic resonance imaging of distal tibia and calcaneus for forensic age estimation in living individuals. Int J Legal Med 129:825–831. CrossRefPubMedGoogle Scholar
  11. 11.
    Wittschieber D, Vieth V, Timme M, Dvorak J, Schmeling A (2014) Magnetic resonance imaging of the iliac crest: age estimation in under-20 soccer players. Forensic Sci Med Pathol 10:198–202. CrossRefPubMedGoogle Scholar
  12. 12.
    Ekizoglu O, Inci E, Ors S, Hocaoglu E, Can IO, Basa CD, Kacmaz IE, Kranioti EF (2019) Forensic age diagnostics by magnetic resonance imaging of the proximal humeral epiphysis. Int J Legal Med 133(1):249–256. CrossRefPubMedGoogle Scholar
  13. 13.
    Ekizoglu O, Inci E, Ors S, Kacmaz IE, Basa CD, Can IO, Kranioti EF (2019) Applicability of T1-weighted MRI in the assessment of forensic age based on the epiphyseal closure of the humeral head. Int J Legal Med 133(1):241–248. CrossRefPubMedGoogle Scholar
  14. 14.
    Hermetet C, Saint-Martin P, Gambier A, Ribier L, Sautenet B, Rérolle C (2018) Forensic age estimation using computed tomography of the medial clavicular epiphysis: a systematic review. Int J Legal Med 132(5):1415–1425. CrossRefPubMedGoogle Scholar
  15. 15.
    Bartolini V, Pinchi V, Gualco B, Vanin S, Chiaracane G, D’Elia G, Norelli GA, Focardi M (2018) The iliac crest in forensic age estimation: evaluation of three methods in pelvis X-rays. Int J Legal Med 132(1):279–288. CrossRefPubMedGoogle Scholar
  16. 16.
    Dvorak J, George J, Junge A, Hodler J (2007) Age determination by magnetic resonance imaging of the wrist in adolescent male football players. Br J Sports Med 41:45–52CrossRefGoogle Scholar
  17. 17.
    Dvorak J, George J, Junge A, Hodler J (2007) Application of MRI of the wrist for age determination in international U-17 soccer competitions. Br J Sports Med 41:497–500CrossRefGoogle Scholar
  18. 18.
    George J, Nagendran J, Azmi K (2012) Comparison study of growth plate fusion using MRI versus plain radiographs as used in age determination for exclusion of overaged football players. Br J Sports Med 46:273–278CrossRefGoogle Scholar
  19. 19.
    Tomei E, Sartori A, Nissman D, Al Ansari N, Battisti S, Rubini A, Stagnitti A, Martino M, Marini M, Barbato E, Semelka RC (2014) Value of MRI of the hand and the wrist in evaluation of bone age: preliminary results. J Magn Reson Imaging 39:1198–1205CrossRefGoogle Scholar
  20. 20.
    Serinelli S, Panebianco V, Martino M, Battisti S, Rodacki K, Marinelli E, Zaccagna F, Semelka RC, Tomei E (2015) Accuracy of MRI skeletal age estimation for subjects 12–19. Potential use for subjects of unknown age. Int J Legal Med 129:609–617. CrossRefPubMedGoogle Scholar
  21. 21.
    Schmidt S, Vieth V, Timme M, Dvorak J, Schmeling A (2015) Examination of ossification of the distal radial epiphysis using magnetic resonance imaging. New insights for age estimation in young footballers in FIFA tournaments. Sci Justice 55:139–144. CrossRefPubMedGoogle Scholar
  22. 22.
    De Tobel J, Hillewig E, de Haas MB, Van Eeckhout B, Fieuws S, Thevissen PW, Verstraete KL (2019) Forensic age estimation based on T1 SE and VIBE wrist MRI: do a one-fits-all staging technique and age estimation model apply? Eur Radiol 29(6):2924–2935. CrossRefPubMedGoogle Scholar
  23. 23.
    Dedouit F, Auriol J, Rousseau H, Rougé D, Crubézy E, Telmon N (2012) Age assessment by magnetic resonance imaging of the knee: a preliminary study. Forensic Sci Int 217:e1–e7. CrossRefGoogle Scholar
  24. 24.
    Timme M, Ottow C, Schulz R, Pfeiffer H, Heindel W, Vieth V, Schmeling A, Schmidt S (2017) Magnetic resonance imaging of the distal radial epiphysis: a new criterion of maturity for determining whether the age of 18 has been completed? Int J Legal Med 131:579–584. CrossRefPubMedGoogle Scholar
  25. 25.
    Altman DG (1991) Practical statistics for medical research. Chapman & Hall, New York 624 ppGoogle Scholar
  26. 26.
    Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) Influence of the examiner’s qualification and sources of error during stage determination of the medial clavicular epiphysis by means of computed tomography. Int J Legal Med 128:183–191. CrossRefPubMedGoogle Scholar
  27. 27.
    Schmeling A, Reisinger W, Loreck D, Vendura K, Markus W, Geserick G (2000) Effects of ethnicity on skeletal maturation: consequences for forensic age estimations. Int J Legal Med 113:253–258CrossRefGoogle Scholar
  28. 28.
    Schmeling A, Schulz R, Danner B, Rösing FW (2006) The impact of economic progress and modernization in medicine on the ossification of hand and wrist. Int J Legal Med 120:121–126CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologyTepecik Training and Research HospitalIzmirTurkey
  2. 2.Department of OrthopedicsTepecik Training and Research HospitalIzmirTurkey
  3. 3.Department of Forensic MedicineTepecik Training and Research HospitalIzmirTurkey

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