Age estimation based on computed tomography exploration: a combined method.

Despite an extensive number of existing methods, age estimation of human remains is still an unsolved matter in the field of forensic anthropology, especially when it comes to mature adults. The specific aim of this work was to propose a combined method for age estimation, for forensic purposes, by coupling the Suchey-Brooks method and the measure of the pubic bone density. For this purpose, we used an independent test sample comprising 339 CT scans of living individuals aged 15 to 99 years old. Measurement of bone density and staging according to the Suchey-Brooks phases were performed, followed by estimation of ages based on a combined method and an existing virtual reference sample. Results highlighted a significant negative correlation between bone density and age. Good accuracy was obtained for the measurement of pubic bone density for age estimation of men and women, especially concerning mature adults, with an absolute error ranging from 9 to 16 years for all individuals. The authors propose a practical combined method consisting of, first, allocating phases according to the scannographic approach of the Suchey-Brooks method. For phases I to IV, the age estimation is given using the Suchey-Brooks method. For phases V to VI, the pubic bone density measurement is used. Further study will be needed to assess the reproducibility of these results on cadavers and dry bones, as the post-mortem process could interfere with the measurement of mineral bone density.

Assessing the fusion of the ischiopubic synchondrosis using predictive modeling.

Flaring of the ischiopubic synchondrosis at the time of fusion is a common clinical observation in pediatrics and represents a normal physiological process in skeletal maturation. When presenting unilaterally, this flaring can mimic a range of serious pathological conditions such as osteomyelitis, osteal tumors, and traumatic injury. An improved understanding of ischiopubic synchondrosis fusion is therefore critical to avoid potential misdiagnosis. Retrospective multi-slice computed tomography pelvic scans of Australian individuals aged neonate to 24 years (n = 184) were assessed using a novel five stage morphological classification system of the maturation and fusion of the ischiopubic synchondrosis. Maturation scoring was conducted using both multiplanar formatting views and volume-rendered reconstructions in OsiriX™. Maturational stage was strongly related to age (P < 0.001) with fusion of the ischiopubic synchondrosis observed between the ages of 4 and 9 years in females and 7 and 13 years for males. The highest probability of fusion in our Queensland Australian population based on multinomial regression predictive modeling was between 7 and 10 years of age. We documented three variants of fusion: pubic and ischial outgrowths, appearance of a secondary ossification center, and a fusiform-shaped enlargement. This study provides the first predictive modeling of the timing of fusion of the ischiopubic synchondrosis using a reliable morphological classification system. The significant variation in timing and progression of fusion of the ischiopubic synchondrosis reported in this study, will aid in minimizing misdiagnosis and unnecessary treatment in children presenting with asymmetrical or delayed ischiopubic synchondrosis anomalies. Clin. Anat. 32:851-859, 2019. © 2019 Wiley Periodicals, Inc.

Image analysis of pubic bone for age estimation in a computed tomography sample.

Radiology has demonstrated great utility for age estimation, but most of the studies are based on metrical and morphological methods in order to perform an identification profile. A simple image analysis-based method is presented, aimed to correlate the bony tissue ultrastructure with several variables obtained from the grey-level histogram (GLH) of computed tomography (CT) sagittal sections of the pubic symphysis surface and the pubic body, and relating them with age. The CT sample consisted of 169 hospital Digital Imaging and Communications in Medicine (DICOM) archives of known sex and age. The calculated multiple regression models showed a maximum R (2) of 0.533 for females and 0.726 for males, with a high intra- and inter-observer agreement. The method suggested is considered not only useful for performing an identification profile during virtopsy, but also for application in further studies in order to attach a quantitative correlation for tissue ultrastructure characteristics, without complex and expensive methods beyond image analysis.

Timing of fusion of the ischiopubic ramus from dry bone observations.

There is little information about the age at which the ischiopubic ramus fuses derived from dry bone observations. This study documents the age ranges for union of the ischiopubic ramus in a sample of 148 known sex and age skeletons from Portugal, with ages ranging from birth to 20 years, using a three-stage scheme. The oldest female with an unfused ramus is 11 years old and the oldest male is 8 years old. The youngest male with a completely fused ramus is 7 years old, and the youngest female is 5 years old. Despite the relatively large sample size, partial fusion was a rare event to record as only two individuals were at this stage and these seemed relatively older than expected (12 and 14 years of age). The likely age interval for partial union of the ramus was subsequently estimated from logistic regression, for both sexes separated and combined. In the sex-pooled sample, the inter-quartile range (25th-75th percentile) for the median age of fusion is 7-11 years and the 10th-90th percentile range is 4-15 years. The scarcity of data on the age of ischiopubic fusion may be related to biases in the sample or to fusion occurring rapidly in this anatomical location. Additional studies may be required to assess the accuracy of the ages reported here, but at present this study provides the most comprehensive assessment of timing of fusion at the ischiopubic ramus from observations of dry bone specimens.

Differential diagnosis in painful ischiopubic synchondrosis (IPS): a case report.

Synchondroses are temporary joints that only exist during skeletal maturation. Bilateral widening of the ischiopubic synchondrosis (IPS) is a normal growth phenomenon, but when it is unilateral and painful it can become a diagnostic challenge. An eight-year-old child with an enlarged symptomatic unilateral synchondrosis is presented. Failure of conservative treatment and its pseudo-tumoral appearance led us to intervene surgically. Pathology revealed a stress fracture. Based on this clinical case, we made a revision of policy regarding pathology, diagnostic workup and treatment strategies for symptomatic synchondrosis.

Estimating differences in volumetric flat bone growth in pediatric patients by radiation treatment method.

PURPOSE: To estimate potential differences in volumetric bone growth in children with sarcoma treated with intensity-modulated (IMRT) and conformal (CRT) radiation therapy using an empiric dose-effect model. METHODS AND MATERIALS: A random coefficient model was used to estimate potential volumetric bone growth of 36 pelvic bones (ischiopubis and ilium) from 11 patients 4 years after radiotherapy. The model incorporated patient age, pretreatment bone volume, integral dose >35 Gy, and time since completion of radiation therapy. Three dosimetry plans were entered into the model: the actual CRT/IMRT plan, a nontreated comparable IMRT/CRT plan, and an idealized plan in which dose was delivered only to the planning target volume. The results were compared with modeled normal bone growth. RESULTS: The model predicted that by using the idealized, IMRT, and CRT approaches, patients would maintain 93%, 87%, and 84%, respectively (p = 0.06), of their expected normal growth. Patients older than 10 years would maintain 98% of normal growth, regardless of treatment method. Those younger than 10 years would maintain 87% (idealized), 76% (IMRT), or 70% (CRT) of their expected growth (p = 0.015). Post hoc testing (Tukey) revealed that the CRT and IMRT approaches differed significantly from the idealized one but not from each other. CONCLUSIONS: Dose-effect models facilitate the comparison of treatment methods and potential interventions. Although treatment methods do not alter the growth of flat bones in older pediatric patients, they may significantly impact bone growth in children younger than age 10 years, especially as we move toward techniques with high conformity and sharper dose gradient.

Early skeletal development in Talpa europaea, the common European mole.

An ontogenetic series of 22 cleared and double-stained prenatal specimens was used to study the sequence of ossification of selected postcranial skeletal elements of Talpa europaea. Results were compared with nine other therian mammals, with Alligator, Chelydra, and Lacerta as outgroups. Using the event-pairing method, shifts in the onset of ossification in T. europaea, Sus, and Homo were identified. In T. europaea, the ossification of the cervical vertebrae starts before the metatarsals. In Homo and Sus, the tarsals ossify before the pubic bone. These shifts in the sequence of ossification are unique among the mammals examined, whereas many other changes, characterising monophyletic groups and/or evolving convergently, were also identified. Particular attention was given to some peculiar calcified elements of the hand in T. europaea, which were identified as accessory ;sesamoid bones', and do not display a chondrified precursor. They start to calcify before all others of the hand and later fuse. They appear in all fingers and function as reinforcement for the distal phalanges, most likely as an adaptation for burrowing. The development of the sesamoid bones was examined using histological sections and macerated adults.

Fisiología de la pubertad femenina / Female puberty physiology

El objetivo del presente artículo es el estudio de la fisiología de la pubertad femenina, con descripción del concepto de pubertad, su cronología, las etapas del desarrollo puberal y los cambios hormonales que acontecen desde la lactancia a la niñez, en la prepubertad y en la pubertad

The aim of this review is the study of female puberty physiology with the description of the puberty concept, its chronology, the several stages of puberty development, and the hormonal changes in the different stages

Asymmetric closure of ischiopubic synchondrosis in pediatric patients: correlation with foot dominance.

OBJECTIVE: The enlarged ischiopubic synchondrosis is a well-known anatomic structure; however, little is known about its physiology. In early childhood, enlargement of this synchondrosis occurs bilaterally, whereas before complete ossification, it is frequently found unilaterally. In most children, the unilateral enlarged ischiopubic synchondrosis is observed in the left hemipelvis, a finding that was hitherto unexplained. During common athletic activities, increased ground reaction forces are exerted on the weight-bearing nondominant limb, which in up to 87% of the general population is the left leg. The asymmetric exertion of these forces may explain the distinct closure sequence of this temporary joint. The purpose of this study was to correlate unilateral enlarged ischiopubic synchondrosis with foot dominance. MATERIALS AND METHODS: The study cohort comprised 32 children who had undergone unenhanced radiography, CT, or MRI for reasons other than bone disorders and who presented with enlarged ischiopubic synchondroses. In these children, the distribution of enlarged ischiopubic synchondrosis and foot dominance were evaluated either retrospectively (n = 11) or prospectively (n = 21). RESULTS: In this cohort, 78% of patients were right-footed and 22% were left-footed. Nine of the 32 children presented with unilateral enlarged ischiopubic synchondrosis (left, seven [78%] of nine; right, two [22%] of nine). All children with enlarged left ischiopubic synchondrosis were right-footed, and all children with enlarged right ischiopubic synchondrosis were left-footed. CONCLUSION: Unilateral enlarged ischiopubic synchondrosis is closely correlated with foot dominance. The asymmetric ossification pattern of the ischiopubic synchondrosis indicates delayed ossification of this anatomic structure due to asymmetrically applied mechanical forces to the nondominant limb.

Fetal bony pelvis in the bladder exstrophy complex: normal potential for growth?

OBJECTIVES: To provide the first look at the bony histologic features of fetuses with the exstrophy complex, specifically evaluating the endochondral ossification, stage of development, and microscopic potential for normal growth. METHODS: Three fetuses between 28 and 30 weeks of gestation, one with classic bladder exstrophy, one with cloacal exstrophy, and one control, were obtained from France. The bony pelves were dissected and preserved in formalin, and multiple representative sections were sliced from all pelvic areas: pubis, ischium, ilium, and sacrum. These slices were sequentially processed as slides, stained with hematoxylin-eosin, and evaluated microscopically for histologic changes, developmental stage, and degree of endochondral ossification. RESULTS: All slides from the three specimens showed cartilage analogue with endochondral ossification. Histologically the exstrophy specimens were identical to the control and appeared completely normal; bone development was occurring at an expected rate with the potential for continued normal growth. CONCLUSIONS: These new findings illustrate that fetal bone in the exstrophy complex displays normal microscopic growth patterns and unhindered endochondral ossification at 28 weeks of gestation, well beyond the embryologic period. With no evident microscopic bony defect, the gross bony anomalies in exstrophy should be surgically correctable, leading us to conclude that early reapproximation of the physiologic shape of the pelvis could lead to more normal gross bone growth, decreased shortage of bone, and a more appropriate distribution of the mechanical and developmental forces on a closed, normally functioning pelvic ring.

[Use of morphologic changes in the pubic symphysis for age determination in the Polish male population]. / Wykorzystanie zmian morfologicznych zachodzacych w spojeniu lonowym do oceny wieku mezczyzn w populacji polskiej.

The aim of this study was to determine if the Suchey-Brooks age at death estimation method could be applied to a male sample from the Polish population. Public symphyses were taken from cadavers of 83 males of age 13-88 years. On the base of the morphological key features every symphysis was qualified to the appropriate age phase. The estimation of means and standard deviations of chronological age of every phase was the next step in the study. The differences turned out to be insignificant for phases I-III and significant for phases IV-VI. These results suggests using the Suchey method only for age estimation of younger males.

Adult females and pubic bone growth.

Previous research (Tague [1994] Am. J. Phys. Anthropol. 95:27-40) has shown an age effect in pubic bone length among adult women. Tague found that in three prehistoric Native American skeletal samples, women aged 18-24 had a significantly shorter linea terminalis than did women aged 25 and older. The purpose of this research is to determine whether such a difference can be discerned in other female skeletal samples. Three female skeletal samples were used in this analysis: 75 African-American and 42 European-American females aged 18-39 from the Hamann-Todd Collection (collected between 1893 and 1938; Iscan, 1990) and 99 African-American females aged 18-39 from the Terry Collection (collected between 1914 and 1965; Cobb, 1933; Iscan, 1990). Several chord measurements of pubic bone length along the linea terminalis were analyzed by one-tailed t-tests of the separate samples subdivided into two age groups: 18-24 and 25-39 years. Of 15 comparisons between age groups, none differed significantly by age group within each sample. It is concluded that the observed significant difference in pubic bone length in the Native American female skeletal samples cannot be replicated in other samples and that there is no age effect on pubic bone length in the samples tested in this analysis. Tague's findings reflect either the occurrence of late menarche in prehistoric populations or differential survivorship.

[Van Neck disease or a variation of ischio-pubic synchondrosis development?]. / Choroba Van Necka czy wariant zarastania chrzastkozrostu kulszowo--lonowego.

Diagnostic problems in the case of 9 years old boy with flared ischio-pubic synchondrosis are presented. The condition is differentiated between Van Neck disease and variation od ischio-pubic synchondrosis development.

The differential development of the hominid pelvis.

The peculiarly shaped hominid pelvis represents the total response to the diverse forces which have moulded its structure, these being requirements for efficient bipedalism and parturition. In some respects the structural requirements of these unrelated functions have been in conflict. In these instances the morphological response to the dominant requirement, viz. bipedalism, is clearly discernible, while the changes subserving the needs of parturition are seen as compensatory modifications, the greater emphasis of which is responsible, in part, for pelvic sexual dimorphism in the female. Total pelvic architecture is thus a mosaic constituted by the aggregate of differential responses to different functional goals.

[Duration of synostosis of the ischiopubic synchondrosis]. / Sroki sinostozirovaniia lonno-sedalishchnogo sinkhondroza

A table of the developmental rate of synostosing pubic-ischiatic synchondrosis is made on the basis of analysis of 305 pelvis roentgenograms of children from 2 till 14 years of age. The obtained data may be used in clinical differential diagnosing between such process and osteochondropathy of pubic-ischiatic synchondrosis as well as for determining the bone age of children