Original communication
Sexing based on measurements of the femoral head parameters on pelvic radiographs

https://doi.org/10.1016/j.jflm.2014.01.004Get rights and content

Abstract

Background and aim

Previous studies have shown that the collo-diaphysial angle varies by race and sex in different populations. This study was performed to compare the femoral head parameters in the two sexes using pelvic radiography in Iranian adults during the August 2011 to August 2012 period.

Materials and methods

This cross-sectional study was done on 100 male and 100 female. After taking hip radiography, collo-diaphysial angle, maximum femoral head diameters and minimum femoral neck width were measured on both sides. Dominant hand, height, weight and body mass index were also recorded. Data were analyzed using SPSS software. Sex differences were tested using independent t-test and ROC curve.

Results

The mean of the right and left maximum femoral head diameters and the minimum width of the femoral neck were significantly higher in men than in women (p < 0.001). The mean of the right collo-diaphysial angle of the femur was significantly higher in men than in women (p = 0.01), but there was no significant difference between the left collo-diaphysial angle in the two sex. The accuracy of sex prediction with the right and left maximum femoral head diameter was 78%. This figure is 77% for the right and left minimum femoral neck widths and 59% for the right collo-diaphysial angle.

Conclusion

If only the proximal part of the femur is available, the sex can be predicted with a relatively high accuracy by taking a radiograph. In our study, the evaluation of the collo-diaphysial angle was not very helpful in sexing.

Introduction

A variety of diagnostic markers for sexing in human remains have been considered by forensic medicine specialists.1 Several anatomical structures have been examined for determining the identity and sex of human being including the skull, pelvis and long bones.1 Due to their high durability, femoral bones are the most useful long bones in sexing. Several factors including femoral length, femoral head diameter and width and angle of the femoral neck have been used for sexing,1 however, body parts and dimensions vary considerably by age and sex among various races and ethnic groups.2

Previous studies have shown higher figure of femoral head diameter1, 3, 4 and femoral neck width3, 5 in men compare than women.

The evolution of man and his anatomically standing position on both feet leads to changes in the structures making up the hip. The collo-diaphysial angle is an important factor for hip stability and normal walking.2 Previous studies have shown that the angle is different based on ethnicity, sex and age.2, 6, 7, 8, 9 The obtuse angle is smaller in women mainly due to their wider pelvis and shorter femur.10 This angle, on average, declines from 150° to 120° at the end of development, but does not change after maturation.11

Alonso and colleagues showed that the collo-diaphysial angle in men and women with hip fracture was significantly larger than the control group.12 Subsequent studies in Africa and Europe demonstrated the regional diversity and sex diversity for this angle.2, 13, 14, 15 The sexual dimorphism of the angle is used in determining the sex in skeletal remains.2, 3, 9, 13

Despite the importance of this angle and extensive studies on different ethnic groups, few studies have been published from Asia.16, 17, 18, 19 Anthropometric parameters of some bones such as the clavicle and the radius in sexing have been evaluated in previous studies in Iran20, 21 but so far, no study has been published in this field from Iran. This study was conducted to compare the femoral head parameters between the two sexes using pelvic radiography in Iranian adults.

Section snippets

Material and methods

This was a cross-sectional study. The study population consisted of Iranian adults (20 years of age and older) who were referred to the radiologic department of Sina Hospital in Tehran for hip radiography from August 2011 to August 2012 (n = 248). The sample size was 200 (100 men and 100 women) and convenience sampling was conducted using the available samples. Samples were enrolled after providing informing about this study and obtaining written consent.

Patients with the following

Results

The mean age of the sample was 39.2 years (the inter-quartile range was 25–49.7 years) with a mean age of 34.6 years (the inter-quartile range was 24–41.5 years) in men and 43.9 years (the inter-quartile range was 28–56.7 years) in women. Twelve men (12%) and 8 women (8%) were left-handed. Reader reliability was good for all collo-diaphysial angle (intra-class correlation coefficient [ICC] = 0.88–0.94).

The mean of the right and left maximum femoral head diameters and the minimum width of the

Discussion

In this study, the mean of the right and left maximum femoral head diameters and the minimum width of the femoral neck were significantly higher in men than in women (p < 0.001). This finding is consistent with previous studies 3, 5, 19, 22, 23 and as expected, the dimensions of the femoral head in men were higher than in women. These differences may be explained by the larger physique of men which is discussed in previous studies.3, 5, 19, 22, 23

In our study, the right collo-diaphysial angle

Conclusion

This study found a significant difference between men and woman in the collo-diaphysial angle, the maximum femoral head diameter and the minimal femoral neck. Based on the results of this study we conclude that the maximum femoral head diameter and the minimal femoral neck provide useful and reliable parameters for sexing, whereas the practical value of the collo-diaphysial angle is more ambiguous. The results are not expansible to other populations, direct measurements and measurements before

Ethical approval

None declared.

Funding

None declared.

Conflict of interest

Nil.

Acknowledgment

This study was part of Dr. Vida Allahyar Parsa's dissertation to get specialized degree in Forensic Medicine. We are grateful for funding from vice chancellor of research of Tehran University of Medical Sciences.

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