Examination of ossification of the distal radial epiphysis using magnetic resonance imaging. New insights for age estimation in young footballers in FIFA tournaments

• Alongside a variety of clinical and forensic issues, age estimation in living persons also plays a decisive role in the field of professional sport.
• Only methods of determining skeletal age which do not expose individuals to ionizing radiation are suitable for this purpose.
• This is the first MRI study evaluating ossification of the distal radius by means of a combination of the classification systems proposed by Schmeling et al. and by Kellinghaus et al.
• According to the results of the present study, the fused epiphyseal plate of the distal radius provides potential maturation criteria which appear suitable for reliable monitoring of all relevant age limits in international football with the aid of MRI.

Alongside a variety of clinical and forensic issues, age determination in living persons also plays a decisive role in the field of professional sport. Only methods of determining skeletal age which do not expose individuals to ionizing radiation are suitable for this purpose. The present study examines whether MRI diagnosis of the distal radial epiphysis can be utilised to monitor internationally relevant age limits in professional football.The wrist area of 152 male footballers aged 18 to 22 years belonging to regional clubs was prospectively examined using MRI. The ossification stage of the distal radial epiphysis was subsequently determined on the basis of established criteria used in determining the maturity of the medial clavicular epiphysis.For the first time, we ascertained evidence of an increase in the prevalence of the phenomenon of threefold linear stratification (hypointense line, hyperintense line, and hypointense line) in the representation of the fused epiphyseal plate of the radius using magnetic resonance imaging with increasing chronological age. Within our study population, test persons with an ossified epiphyseal plate without any verifiable epiphyseal scar were not represented. The presumably high minimum age of entry into this final stage of development (> 22 years) must be verified in the course of further studies.According to the results of the present study, the fused epiphyseal plate of the distal radius provides potential maturation criteria which appear suitable for reliable monitoring of all relevant age limits in international football with the aid of magnetic resonance imaging.