Computed Tomographic Analysis of Medial Clavicular Epiphyseal Fusion for Age Estimation in Western Indian Population: A Cross-sectional Study

Introduction: Forensic age estimation is important in cases related to sexual assault, murder, skeletal remains, and juvenile crimes, where the age of the suspect or victim is unknown. The literature indicates that the age of fusion of the medial clavicular epiphyseal varies from region to region. Aim: To estimate age from medial clavicular epiphyseal fusion through computed tomographic analysis. Materials and Methods: This was a cross-sectional observational study with a sample size of 384, conducted over 24 months from January 2020 to December 2021 in the Department of Radiology at a tertiary care centre, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India. The study population included patients who underwent a Computed Tomography (CT) scan of the chest, aged between 18 and 35 years. They were arbitrarily divided into six age groups: 18-20 years, 21-23 years, 24-26 years, 27-29 years, 30-32 years, and 33-35 years. The Schmeling classification was used for age estimation. Chronological age served as the constant, while the stages of radiological fusion of the medial clavicular epiphyseal were the variables. Age estimation by this method involved observing the chronological age at a particular stage of fusion. The mean age of fusion at each stage was calculated. The association among variables was analysed using the Analysis of Variance (ANOVA) test for definite variables. In the present study, the level of significance was set at 0.05. Results: Of the 384 participants (mean age 26.3±5.1 years; 217 men), 279 (72.7%) showed complete fusion of the medial epiphyses of the clavicle (stage 4 and stage 5). The mean age for medial clavicular epiphyseal fusion in men was 22.66±1.3 years, while for women it was 21.86±1.09 years. The mean age at which stage 5 was achieved was 29.6±3.37 years, indicated by complete fusion without the epiphyseal scar. Conclusion: The study concludes that all men and women with complete fusion of the medial clavicular epiphyseal were older than 22.6 and 21.8 years of age, respectively