The role of CT analyses of the sternal end of the clavicle and the first costal cartilage in age estimation

The ossification patterns of medial clavicle and the first costal cartilage represent interesting features of the same anatomical region which are accessible for conventional radiographic and computed tomography (CT) examinations in the same field of view. This study encompassed Serbian population and was carried out to examine whether CT analyses of medial clavicle and the first costal cartilage could be successfully applied, either individually or conjointly, in the age assessment. The study was based on CT examinations of thoracic region of 154 patients, aged between 15 and 35 years. Besides radiodensity and stages of epiphyseal cartilage ossification of medial clavicle, the study detected other features that expressed significant correlation with age, such as calculated anterior to posterior cortical thickness ratio, medullar canal diameter, and clavicular shaft diameter. However, although calculated ossified and calcified linear projections’ (OCP) stages correlated to age, the distinction between stages was not satisfying. The interaction between the ossification status of medial clavicle and OCP was not significantly influenced by age. The results of our study outlined interesting new age predictors with mutual relationship: acquired radio density of the sternal epiphyseal-metaphyseal region and radio density of the first costal cartilage. Intersex variability was observed in several age-related features: calculated anterior to posterior cortical thickness ratio, diameter of medullar canal, and diameter of the clavicular shaft. Altogether, our study identified several radiological features of the first costal cartilage and medial clavicle that correlated with age and which could be applied as additional guidance for age estimation in each specific case.