Journal of Forensic Research

CT-Scan Bone Clavicle Imaging for Age Determination: A Clinical Study

Abstract

Simina Elena Chiriac and Bernard Marc*

Age assessment remains a complex process with possible far-reaching consequences for applicants undergoing the assessment. Age assessment methods and processes differ across European Union Member States since age of majority differs from one State to another one. A number of challenges are faced during the undertaking of the age assessment process, such as the limitations of the methods in use concerning intrusiveness and accuracy, fragmented estimations based only on the physical appearance and the accuracy of medical methods, including ionising ones. The European Asylum Support Office practical guide on age assessment states that since no single method currently available can determine the exact age of a person, a combination of methods assessing not only the physical development but also the maturity of the applicant can reduce the range of age in question. Skeletal age is determined from the development stage of bones estimated with development stages from the fusion/maturation of specific bones. The main methods of X-ray include carpal, collarbone, dental or hip. In our Forensic Medical Unit and Radiology Department of GHEF, widest public hospital in the South-Eastern region of Ile-de-France, we make use of these methods in combinations. Carpal, dental and hip fusion/maturation differ mainly from one ethnic group to another one. CT-scan bone clavicle imaging for age determination seems to be the most reliable current method. The aim of this study was to confirm the accuracy of CTscan method described in previous studies by comparing our results. Their peculiar interest was that they have been obtained from a various ethnic population from wide Paris suburb during COVID pandemia where thoracic CT scanners have been widely prescribed to young people with accurate birth dates. We discuss the main sources of error in stage and sub-stage evaluation in this study which are some anatomical variants. Finally, although there is a great ethnic, cultural and socio-economic diversity in the East Paris region, our retrospective evaluation shows that the age estimation method based on the maturation of the clavicular sternal epiphysis can be successfully applied in this location. The results of our study are close to the previous referenced studies and stage 3C of Schmeling classification is clearly the limit over which the age of 18-year-old is reached.