Using Multi-Slice Computed Tomography In Age Estimation Based on the Fusion of the Sternal Elements among Group of Egyptian Subjects

Document Type : Original Article

Authors

Departments of Forensic Medicine & Clincal Toxicolcogy and Radiodiagnosis, Faculty of Medicine, Zagazig University,AL Sharqia, Egypt.

Abstract

Objectives: Determination of age from human skeletal remains for forensic and medico-legal purpose is an important matter in civil and criminal cases. Radiological examination of sternum especially fusion of sternal segments offer considerable help. Computed tomography (CT) is rapidly becoming the gold standard for analysis of skeletal and dental development in both clinical and increasingly, in forensic practice. The purpose of the present study was   to estimate age from the assessment of the degree of fusion of xiphoid process and manubrium with mesosternum using the utility of multi-slice C T. Subjects and Methods: The study includes 100 subjects consisting of 49 males and 51 females. The age groups included in the study ranged from 30 to 65 years (yrs). The fusion status of xiphoid process and manubrium with the mesosternum were evaluated for degree of fusion: complete, partial, absent by using multislice CT scan. Results: fusion of xiphoid with mesosternum  In male and female groups, began after 30 yrs of age but the fusion was not complete within 30 to 40 yrs. From 45 up to 55 yrs, closure was invariable with different degrees.  From the age of 55 up to 65 yrs, all subjects showed complete fusion. Complete fusion started earlier in female group (at 35 to 40 yrs) than in male group that began (at 40 to 45 yrs). While fusion of manibrium with mesosternumin male group < /em> began after 45 yrs of age. The fusion was invariable in the age from 50 up to 60 yrs old. From the age of 60 to 65 yrs all subjects showed complete fusion. In female group < /em> partial fusion began from 40 up to 45 yrs of age. In the age from above 45 to 60 yrs the fusion was invariable. From the age of 60 to 65 yrs all subjects showed complete fusion. It was also noticed that partial fusion started earlier in female group ( at 40 yrs ) than  in male group that began (at 45 yrs). Conclusion: From the previous results it can be concluded that applicating multi-slice CT- based age diagnostics assessment of the degree of fusion of the xiphoid process and manubrium with mesosternum could be helpful in estimation of age. The fusion of the xiphoid process with the mesosternum began after the age of thirty. The fusion was present in uneven degrees up to the age of forty-five. In most of subjects the fusion is complete after the age of fifty. The fusion of the manubrium with the mesosternum began after the age of forty. The fusion was present in varying degrees in subjects above fifty five years. Complete fusion, when present, occurs after the age of fifty. All these data could be helpful in determination of age from sternal bone.

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