AGE DETERMINATION

1. AGE DETERMINATION

2. Why do we need to estimate age ? Criminal claims � as in sexual assault Civil conditions as in Improper birth registration: for marriage, work, military recruitment Amnesia Refugees Introduction

3. Methods of age estimation 3 Bs: Belongings: IDs, birth certificate Behavioral markers: Mentality and behavior: infant developmental milestones: motor, cognitive, language, social Education Voice and language Biological markers: Non-skeletal Skeletal

4. Methods of age estimation Biological: Non-skeletal: General appearance: e.g. height, weight Development : Infant developmental milestones: physical Sexual development: Primary sex characters Secondary sex characters Aging: skin wrinkles, hair color

5. Methods of age estimation Biological: Skeletal: Teeth examination Dentition Attrition Ossification centers Closure of epiphysial plates Skull: Dimensions Closure of fontanels Closure of sutures

6. Methods of age estimation Most important methods: General development in children Secondary sexual characters Teeth examination Ossification centers Obliteration of growth plates

7. Age during intrauterine life: In claims of criminal abortion, maternal deaths, and rape. Estimated during pregnancy by ultrasonography and date of the last menstrual period Age from birth up to 18 years Age after 18 years

8. From 0-15 days (neonatal period) By umbilical stump examination From 15 days - 2 years(Infancy period) By primary dentition From 2- 6 years Closure of metopic suture Appearance of ossific centers From 6-12 years Secondary dentition

9. From 12- 18 (Adolescence period). Closure of epiphysial plates Adulthood Early stage: bone remodeling and maintenance Late stage: bone wear and tear

10. Dentition

11. Dentition � milky teeth

12. Dentition � permanent teeth

13. Dentition � permanent teeth

24. 1 year: head of humerus ,femur, tibia 2 years: lower radius 3 years: patella 4 years: upper fibula, greater trochanter 5 years: lower fibula 6 years: upper radius, calcaneus Appearance of ossification centers after birth

25. Below1 year as ossific center of the head of femur not appeared. Appearance of ossification centers after birth

26. > 1 year (ossific center at head of femur) Appearance of ossification centers after birth

27. Below 2 years (no ossific centre in the wrist) Appearance of ossification centers after birth

28. Above 2 years: ossific center of lower radius Appearance of ossification centers after birth

29. Obliteration of growth plates

30. Obliteration of growth plates

31. Obliteration of growth plates

32. Obliteration of growth plates � upper limb

34. What is the age ? <19 (not united head of humerus with the body)

35. What is the age ? >19 years (united head of humerus)

36. What is the age ? >17 y (completely developed elbow)

37. What is the age ? < 19 ( non united lower ends of radius and ulna)

38. What is the age ? > 19 years ( closed lower ends of radius and ulna)

40. What is the age?

41. Obliteration of growth plates

42. Obliteration of growth plates - lower limb

43. What is the age?

44. What is the age?

45. What are the ages?

46. What are the ages ?

47. What are the ages ?

48. Obliteration of growth plates - sternum

49. < 15 y (non-united segments) What is the age?

51. Two pubic rami of the hip (6y) Suture at the acetabulum (15) Ischeal tuberosity with the ischium (21y) Iliac crest with the ilium (23y)

52. What is the age ? > 1 y (ossific center at femoral head) <4 y (ossific center at greater trochanter)

53. What is the age ? >4 y (ossific center at greater trochanter) <15 y (triradiate suture is opened)

54. What is the age ? >4 y (ossific center at greater trochanter) <15 y (opened triradiate suture)

55. What is the age? <23 y (iliac crest)

56. What is the age? >23 y (iliac crest)

57. 6 years Age of education (1st molar and pubic ramus) 7 years Age of discrimination (Central incisors) 10 years In case of divorce father claims his son (Second premolar) Ages of legal importance in Egypt

58. 12 years Father claims his daughter (2nd molar) 14 years: Under this age The child cannot commit the crime of rape Child work is not legal (Union of the trochlea and capitulum, calcaneus body and epiphysis) Ages of legal importance in Egypt

59. 15 years The custody of the mother ends for both son and daughter and they are allowed to choose their custodian till age of21 for son or marriage for daughter The child is considered partially responsible i.e. trial in front of juvenile court (Union of trochlea and capitulum with lower end of humerus.+ acetabular suture union) Ages of legal importance in Egypt

60. 16years Age of legal marriage in females Identity card (Metecarpals in females) 18 years: Legal marriage in males Legal age for consent Governmental employment Driving license Full criminal responsibility Voting Military recruitment ( Metacarpals) Ages of legal importance in Egypt

61. 21 years Civil rights (X - ray knee) 30 years Member of people assembly (Sagittal suture) 35 years Legal age of the president of the public 60 years Pension (Union of body and manubrium of sternum) Ages of legal importance in Egypt

62. Post test Ques. 1 Write the estimated age for the following: Pic.1

63. Ques 2 Pic 2

64. Quest. 3 Pic 3

65. Quest 4 Pic 4

66. Quest. 5 pic5

67. Quest.6 Pic 6 55

68. Quest.7Which is older a or b? a b

69. Quest.8 For more precise age estimation for the pic a I need to ask for x ray: Knee Ankle Elbow pelvis

70. Quest.9 For more precise age estimation for the pic b I need to ask for x ray: Sternum Knee Shoulder hip

71. Quest 10Suggest which picture is older a or b and why?  a b