Estimating the skeletal age from two and three-dimensional computed tomography reconstructions of the pubic symphysis and the fourth rib

Summary Objectives To determine the correct age in legal procedures is paramount in obtaining the age of majority. This study was designed to prioritize a reliable postcranial age estimators capable of accurately assessing ages around 18 years. Methods In this retrospective study, we used a two-step procedure (Iscan–Loth and Suchey–Brooks methods) to estimate the age range. CT test sample included 102 pubic symphysis and sternal end of the 4th ribs from male individuals aged from 13.5 to 87 years (median: 20.3). Two-D and 3D-CT reconstructions were performed. Analysis of the correlation between our age range estimation and the chronological age was performed using the Pearson, Lin, and Kappa coefficients and Bland–Altman analysis. Results In our study, we reported 97% of subjects for whom the estimate of their age compared to legal age of 18 years was feasible through this method. The Kappa coefficient between our age estimation compared to the legal age was 0.905. Conclusions Estimation of the legal age through CT scan, of the pubic symphysis and the distal end of the 4th rib, seems reliable and well correlated with whether the individual has more or less 18 years old.