Age estimation by Radiological examination:

Of the four of data utilized for determination of age:-

1. Psychological data
2. Physical data
3. Dental data and
4. Radiological data

Radiological data is accepted to be the most reliable.

 Radiological data can easily be determined by studying appearances of

ossification centres and their fusion with the adjacent centres by
radiological examination of the bones.

 The bones of the whole skeleton develop from the preformed hyaline
cartilage by the process of “Osteogenesis”.

 Large number of Ossification centres appear in the preformed cartilage at

different periods of life.

 At 11 to 12th week of intrauterine life there are 806 ossification centres.

 At birth they are about 450 and an adult skeleton contains only 206
bones.

 Usually in epiphyses, ossification starts centrally and then spreads to the

periphery.

 To the start with the centres is small, rounded, size of a pinhead, as it

grows it takes the shape of the bone.

 Small bones like, carpal, tarsal bones grow from single centre, where as
long bones grow from multiple centres.

 Shaft or diaphysis of most of the long bones develop from one centre
while the ends or the epiphysis are developed from separate centres.

 These epiphyseal centres are secondary centres.

 Increase in length of long bones occur in the layrerof cartilage persisting

in between the diaphysis and epiphysis, until it attains the adult shape and
size.

 Both the terminal ends of the long bones of the times develop from
separate ossification centres, white the ends of the bones like clavicle, rib,
metacarpal, metatarsal develop from one epiphysis at one end only.
  The process of fusion of epiphysis with diaphysis is called “Union’.
Union may be interpreted as (a).Not united (b) Uniting (c) united, all on
the basis of stage of union.

 Epiphyseal union occurs 1 to 2 years earlier in females than in males.

 Epiphyseal union is earlier in tropical countries than in temperate zones.

 The radiological bony union is 2 to 3 years earlier than anatomical bony

union

 The time of bony epiphyseal union is not same throughout India. It differs
even up to 2 to 3 years from south to north, east to west.

Joints are to required to be examined frequently for estimation of Age:

1. Elbow joint (AP& Lateral view).

2. Wrist joint (AP & Lateral view).

3. Pelvis (AP view).

4. Pelvis (AP view) with intrauterine foetal death.

5. Should joint (AP & Lateral view).

6. Knee joint (AP & Lateral view).

7. Ankle joint (AP & Lateral view).

8. Chest (AP view) with sterno – clavicular joints.

9. Chest (Lateral view) with sternum and vertebrae.

10. Skull (AP, Lateral and Profile view).

Medico – legal opinions can be drawn from X-ray.

1. Age.

2. Sex.

3. Injury.

4. Pathology.
TABLE SHOWING AGE OF APPEARANCE AND FUSION OF SOME OF EPIPHYSIS
AS PER GALSTAUN’S CHART.

MALE FEMALE
S.NO EPIPHYSIS Appearance Fusion Appearance Fusion
(in years) (in years) (in years) (in years)
1. Sternalend of clavicle 15 - 19 22 14 - 16 20
2. Tip of coraccoid process 10 - 11 16 10 - 11 16
3. Acromion process 14 - 17 14 - 19 12 – 14 13 - 16
4. Head of humerus 1 14 - 18 12 - 14 13 -16
2 – 4 with 2-4 with
head 5 -7 with head 5 - 7
5. Greator tubercle of humerus - -
lesser with lesser
tubercle tubercle
14 with
6. Medical epicondyle of humerus 7 16 with shaft 5
shaft
11- 16 with 10 -12 with
7. Lateral epicondycle of humerus 12 10
capitulum capitulum
11- 15 with 9 -13 with
8. Trochlear of humerus 11 10
capitulum capitulum
9. Head of Radius 8 16 6 14
10. Tip of olecranon 11 -13 17 9 -12 15
11. Lower end of Radius 1 16 - 17 1 161/2 – 18
12. Lowerend of ulna 10 -11 18 8 - 10 17
13. Iliac crest 17 19 - 20 14 17 -19
14. Ischial tuberasity 16 -18 20 14 - 16 20
15. Head of femur 1 16 -17 1 14 -15
16. Greater trochanter - 15 -17 - 15 -17
17. Lesser trochanter - 17 - 14
15 -16 14
Disappearance Disappeance
18. Acetabulum - -
of triradaate of triradaate
carlage carlage
At or before At or before
19. Lower end of femur 14 -17 14- 17
birth birth
At or before At or before
20. Upper end of tubia 15 -17 14 -15
birth birth
21. Upper end of fibula - 11 -16 - 14 - 16
22. Patella 3 -7 - 4 -
23. Lower end of tibia - 16 - 14.1 -14.4
24. Lower end of fibula - 14 - 16 - 13 -15
25. Trapezium 7 - 5 -6 -
26. Trapezoid 4 -7 - 5 -6 -
27. Capitate 1/2 - 1/2 -
28. Hamate 8 -14 - 8 -14 -
29. Scaphoid 7 -11 - 6 -
30. Lunate 5 - 5 -
31. Cuneiform 3-4 2-3 -
32. Pisiform 12 - 17 - 9 - 12 -
33. 1st metacarpal 4 12 -17 3 9 -12
34. 2nd 5th metacarpal 3 -4 16 - 18 2 -3 14 -15
35. Proximal carpal phalanges 2 -4 17 -18 1 1/2 14 - 15
36. Middle row of carpal phalenges 3 16 -18 2 -3 14 -15
37. Distal row of carpal phalenges 3 -5 17 - 18 3 15
38. Calanium, cubiod talus At birth - 1 -3 -
39. Internal cuniform 1 -4 - 1 -3 -
40. Middle- Cuniform 2 -4 - 1 -3 -
41. External cuniform 1 -4 - 1 -3 -
42. Navicular 2 - 1 -3 -
43. Metatarslas 4 -5 16 - 18 1 -3 14 -15
44. Proximal row of tarsal phalanes 2 -4 16 -18 1 -3 14 -15
45. Middle row of tarsal phalenges 3 -4 16 -18 3 -4 14 - 15
46. Distal row of tarsal phalenges 4 -6 15 -17 4 -6 13 -14