AGE IDENTIFICATION FROM BONES

D i.e. Iliac crest & clavicle

The following data is used for radiologically age determination.

* Way of remembering : By radiological examination of wrist we can determine age of 16, 17, 18, 19; From shoulder 17, 18, 19, 20 & from crest of ilium examination 18, 19, 20, 21. These all are 4 continuous numbers starting from 16 from wrist, 17 for shoulder & 18 for crest of ilium. Also remember that P^t two years are for girls & last two for boys. Radiological examination of elbow is done for age determination before this i.e. 13 – 16 yrs. & R.E. of Ischial tuberosity & Clavicle inner end is done for 21, 22, 23, 24 age group (I^st 2 years for girls & last 2 years for boys).

Ans is ‘b’ i.e., Wrist

Radiograph used to determine skeletal age

• 3-9 months → Shoulder
• 1-13 years → Hand and wrist
• 12-14 years → Elbow and hip

Ans. 19 years

The suture marked by an arrow above represents a metopic suture.

• The metopic suture (also known as the median frontal suture) is a type of calvarial suture. It is often associated with frontal sinus agenesis or hypoplasia.
• This suture runs through the midline across the frontal bone from the nasion to the bregma although it may often be incomplete.
• The metopic suture is usually closed by about 6 years of age, but in rare cases, it can persist as an anatomical variant of little clinical significance but that it can be mistaken for frontal bone fracture.
• Premature fusion of the suture is termed metopic synostosis (a type of craniosynostosis) which can then result in trigonocephaly.

Ans; A).Below 2 years

The given X-ray is of a child who is below 2 years of age as there is no ossific center in the wrist.

Ossification of the wrist can be divided into two components:

• Carpal bone ossification centers
• Distal radial and ulna ossification centers

Ossification of the carpal bones

Ossification of the carpal bones occurs in a predictable sequence, starting with the capitate and ending with the pisiform.

At birth, there is no calcification in the carpal bones. Although there is great individual variability, approximate ossification times are as follows:

• Capitate: 1-3 months
• Hamate: 2-4 months
• Triquetrum: 2-3 years
• Lunate: 2-4 years
• Scaphoid: 4-6 years
• Trapezium: 4-6 years
• Trapezoid: 4-6 years
• Pisiform: 8-12 years

Excluding the pisiform, a handy way to remember the order of ossification is to start at the capitate then move in a counterclockwise direction on the volar surface of the right carpus.

Ossification centers of the distal radius and ulna

• Distal radius: 1 year
• Distal ulna: 5-6 years

Ans;A).Above 2 years.

The approximate age of the child is above 2 years as in the given X-ray there is an ossific centre of lower radius.

Ossification of the wrist can be divided into two components:

• carpal bone ossification centres
• distal radial and ulna ossification centres

Ossification of the carpal bones

Ossification of the carpal bones occurs in a predictable sequence, starting with the capitate and ending with the pisiform.

At birth, there is no calcification in the carpal bones. Although there is great individual variability, approximate ossification times are as follows:

• capitate: 1-3 months
• hamate:  2-4 months
• triquetrum: 2-3 years
• lunate: 2-4 years
• scaphoid: 4-6 years
• trapezium: 4-6 years
• trapezoid: 4-6 years
• pisiform: 8-12 years

Excluding the pisiform, a handy way to remember the order of ossification is to start at the capitate then move in a counterclockwise direction on the volar surface of the right carpus.

Ossification centres of the distal radius and ulna

• distal radius: 1 year
• distal ulna: 5-6 years

Ans. c. 17-19 years

According to Galstaun method, iliac crest fuses in females at the age of 17-19 years.

• Galstaun 1937 On Bengalis (Indian): Epiphyseal Fusion in Iliac Crest; Male: 19-20 years and Female: 17-19 years.’

http://medind.nic.in/jal/t11/il/jaltIlilp24.pdf Estimation of Age from Epiphyseal Fusion in Iliac Crest (J Indian Acad Forensic Med. Jan-Mar 2011, Vol. 33, No. 1) Table no. 4

• Galstaun G observed fusion of iliac crest in bengali girls, between 17-19 years which is earlier.
• Dasgupta et al in Uttar Pradesh found fusion of the iliac crest at 19-20 years, which is similar with majority of the cases in this study.