Forensic age estimation based on magnetic resonance imaging of the knee joint: a systematic review

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Abstract

Background: The issue of age assessment is not only relevant in modern society but also socially significant. According to official statistics, 2021 saw a record number of migrants and refugees — over 89 million and 27.1 million, respectively. A significant proportion of them are children and adolescents under the age of 18, many of whom lack proper legal documents confirming their date of birth. In such cases, forensic age determination is necessary. From the perspective of safety and effectiveness, magnetic resonance imaging is considered the method of choice for age assessment. This highlights the need to explore its potential as a method for documenting and assessing the developmental status of the studied anatomical structure.

Aim: To analyze published data on the feasibility of using knee magnetic resonance imaging findings to determine the stage of epiphyseal ossification for forensic age estimation in children, adolescents, and young adults.

Materials and methods: A study protocol was developed and registered in PROSPERO (registration number CRD42022344779, 2022). Several search engines were used, including PubMed, Web of Science, and the Scopus database, to ensure a comprehensive review of current knowledge. Articles published in English from 1985 to 2021 were considered. Literature searches were conducted using the following keywords and term combinations: “age estimation”, “age determination”, “knee”, and “magnetic resonance imaging of the knee”.

Results: A total of 13 publications were selected and thoroughly analyzed. Differences among the studies were identified regarding magnetic resonance imaging research protocols, classifications used for determining the stage of epiphyseal ossification by age, and the specialization and experience level of the researchers. Significant heterogeneity in population samples was noted, including variations in the number of study subjects, the age range, and the uneven distribution within age groups.

Conclusion: The amount and heterogeneity of data in the studies included in this systematic review did not allow for a meta-analysis of the results or for predicting the risk of misclassification in the target age group. Therefore, at present, MRI-based knee age assessment cannot be considered an objective and legally substantiated forensic method.

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About the authors

Dmitry D. Zolotenkov

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: Zolotenkovaspir@mail.ru
ORCID iD: 0000-0002-1224-1077
SPIN-code: 1352-8848
Россия, Moscow

Natalia S. Serova

Sechenov First Moscow State Medical University (Sechenov University)

Email: serova_n_s@staff.sechenov.ru
ORCID iD: 0000-0003-2975-4431
SPIN-code: 4632-3235

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

Moscow

Galina V. Zolotenkova

Sechenov First Moscow State Medical University (Sechenov University)

Email: zolotenkova_g_v@staff.sechenov.ru
ORCID iD: 0000-0003-1764-2213

MD, Dr. Sci. (Medicine), Assistant Professor

Россия, Moscow

Maria P. Poletaeva

Sechenov First Moscow State Medical University (Sechenov University)

Email: poletaeva_m_p@staff.sechenov.ru
ORCID iD: 0000-0003-0542-100X
SPIN-code: 4910-8281

MD, Cand. Sci. (Medicine)

Россия, Moscow

Yuri I. Pigolkin

Sechenov First Moscow State Medical University (Sechenov University)

Email: pigolkin@mail.ru
ORCID iD: 0000-0001-5370-4931
SPIN-code: 1426-5903

MD, Dr. Sci. (Medicine), Proffessor, Corresponding Member of the Russian Academy of Sciences

Россия, Moscow

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2. Fig. 1. PRISMA 2020 flow chart for a systematic review including database and search engine searches.

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3. Fig. 2. Results of magnetic resonance imaging of the knee joint in the coronal plane, T2-weighted images [64]. Stages of ossification of the proximal tibial epiphysis and distal femoral epiphysis according to the classification of F. Dedouit et al. (2012): a — stage I; b — stage II; c — stage III; d — stage IV; e — stage V.

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4. Fig. 3. Results of magnetic resonance imaging of the knee joint in the coronal plane: a — T1-weighted image; b — T2-weighted image [63]. Ossification stages of the proximal tibial epiphysis and distal femoral epiphysis according to the classification of V. Vieth et al. (2018). TSE — turbo spin echo; SPIR — signal pre-saturation with inversion recovery.

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