Age estimation in the living : a test of 6 radiographic methods

There is a growing recognition that there is a requirement for methods of age estimation of the living to be rigorously tested to ensure that they are accurate, reliable and valid for use in forensic and humanitarian age estimation. The necessity for accurate and reliable methods of age estimation are driven both by humanitarian, political and judicial need. Age estimation methods commonly in use today are based on the application of reference standards, known as atlases, which were developed using data collected from children who participated in longitudinal studies in the early to mid-1900s. The standards were originally developed to provide a baseline to which radiographs could be compared in order to assess the child’s stage of skeletal development in relation to their chronological age, a purpose for which they are still utilised in the medical community. These atlases provide a testable link between skeletal age and chronological age which has been recognised by forensic practitioners who have essentially hijacked this medical capability and applied it to their fields. This has resulted in an increased use of these standards as a method of predicting the chronological age from the skeletal age of a child when the former is unknown. This novel use of the atlases on populations who are distinct, ethnically, temporally and geographically, from those whose data was gathered and was used in the design of the standard leaves the forensic outcomes vulnerable to challenge in court. This study aims to examine the reliability and accuracy of these standards in relation to a modern population, providing a sound statistical base for the use of these standards for forensic purposes. Radiographs were collected from the local hospital from children who had been X-rayed for investigation during attendance at the local A&E department. Four body areas were selected for investigation; the hand-wrist, the elbow, the knee and the foot-ankle and tests were undertaken to assess the radiographs using six commonly uses methods of age estimation. Further images of the wrist and elbow were collected from children in New Delhi, India. These images were subject to age estimation utilising the methods described.