Evaluation Of Distal Femoral Epiphysis And Proximal Tibial Epiphysis Ossification Using The Vieth Method In Living Individuals: Applicability In The Estimation Of Forensic Age

In this study, ossification stages of distal femoral epiphysis and proximal tibial epiphysis were retrospectively evaluated with a 1.5-T magnetic resonance imaging (MRI) scanner according to the newly developed five-stage Vieth method. A total of 367 male and 231 female patients aged 12-30 years were scanned between January 2012 and July 2019. A 1.5-T MRI scanner was used to obtain a T1-weighted turbo spin-echo (TSE) sequence and a fat-suppressed proton density-weighted TSE image. The kappa statistics were good level of agreement for inter- and intra-observer evaluations of the ossification stages for knee. Comparison of male and female data revealed significant between-sex differences in the ages when the stages 3, 4 and 5 ossifications of the distal femoral epiphysis and the stages 4 and 5 ossifications of the proximal tibial epiphysis were first detected. In the proximal tibial epiphysis, stage 6 was observed at age 18 years for males and at age 17 years for females. In the distal femoral epiphysis, stage 6 was initially observed at age 20 years for both sexes. Thus, stage 6 ossification, which is determined through 1.5-T MRI of the knee joint, allows for the determination of the completion of the 18th year of life in either sex.