Age estimation of a Thai population based on maturation of the medial clavicular epiphysis using computed tomography

Ossification of the medial clavicular epiphysis plays an essential role in age estimation for forensic analyses. This study was designed to assess clavicular development in a Thai population using thin-slice computed tomography. Ossification status of the medial clavicular epiphysis was determined in 409 patients using a 5 stage classification by Schmeling et al. Stages 2 and 3 were further subclassified into early (stage a), intermediate (stage b), and late phases (stage c) using criteria from Kellinghaus et al. The sub-stage classification increased accuracy of age estimation particularly within stage 3. Results from this study can be used as a more accurate, Thai specific reference for estimating age. For Thai legal proceedings, we recommend using stage 4 of maturation to represent age > 18 years and stage 5 occurring at >20 years.