Evaluation of the ossification of the medial clavicular epiphysis with a digital ultrasonic system to determine the age threshold of 21 years

In this study, both medial clavicular epiphyses of 77 men were evaluated by two researchers with a digital ultrasound system. The degree of ossification was classified in four stages according to Schulz et al. (Int J Legal Med 122:55–58, 17). Of the test persons over 21 years of age, stage 4 was found bilaterally in 25 (60%), while for five (12%) stage 4 was found on only one side; 12 (28%) further subjects did not show stage 4 on either side, although nine were exactly 21 years old. For the subjects under 21 years of age, stage 4 was found bilaterally in three cases (8.5%), and in three additional cases stage 4 was found on one side. Particularly, the three cases in which stage 4 was diagnosed bilaterally before completion of the 21st year of age limit the value of the used examinatory technique. For these cases it would be interesting to know if parts of the epiphyseal plate that might have been obstructed from the view of the ultrasound transducer would have been visible with CT.