Determinación de edad ósea en adolescentes. Estudio radiológico de pie y tobillo

Abstract

The need to determine age in young people has currently been a subject of interest in courts of justice in order to establish if they have or have not reached legal adult age. This has been a problem for a long time in Legal and Forensic Medicine which also has implications in Forensic Anthropology, since the need arises on numerous occasions to determine age in skeletized subjects. In the field of Legal and Forensic Medicine, determination of child bone age has enormous importance when establishing the possible identity of a child in civil as well as forensic cases. Advances in forensic sciences in the last few decades have pushed forward the development of new and better techniques to estimate age in the skeleton. Age estimation implies the observation of morphological features in skeletal remains, comparison of this information with changes obtained from studies on a recent population with known age, and consideration of possible confusion factors (race, sex, �) which may exist between the unknown population and the population to be studied. In order to estimate age we must use knowledge about chronological changes which occur in the skeleton. These changes do not occur at the same time or at the same rate in different bones and structures, which will lead us to calculation of age estimation. Morphological methods to determine age are based on transformations in bone during growth and over the years. These are particularly pronounced in extreme periods of life, infancy and old age, but slow and little evident in intermediary ages. Whitaker et al (2002) (1) consider the fusion of epiphysarial and diaphysarial nuclei of different bones of the foot (calcaneus, metatarsals and phalanges) indicating in their results that these would be useful as a diagnostic method of age between birth and 150 months of age in females and 200 months of age in males. Hernández et al (1991) (2) presented a study on Spanish population about use of Xrays of the foot for diagnosis of maturation rate; they studied the distal epiphysis of the perone and tibia, the calcaneus and the cuneus in order to evaluate growth rate; they observed that in children between the ages of 0 and 2 years the method was extremely precise. Banerjee and Agarwal (1998) (3) published a study in which they analysed the correlation, with age, of epiphysarial fusion of distal epiphysis of tibia and perone, evaluating its efficiency as a diagnostic method of age between 16 and 17 years in a population from India, with similar results to those described by Crowder and Austin (2005) (4) on the multiracial American population. The objective of this work is to make a study of the current Spanish population to define growth standards which will be able to serve as a reference and which will allow us to determine age in adolescent individuals to compare our results with those obtained by other authors.