Age estimation by ossification stages of the medial clavicular epiphysis: a systematic review

Abstract

Key message This systematic review summarizes the evidence on the distribution of chronological age from pre-defined stages of clavicular ossification studied by MRI or CT in living individuals. We included ten observational studies, all published within the last five years. The studies were conducted in five different countries, involving 4190 participants. Nine studies used CT and one used MRI. The QUADAS-2 checklist was used to assess risk of bias. The mean chronological age and its 95 % confidence interval (95% CI) were presented for males and females separately in each stage and substage of medial clavicle epiphysis. Most of the studies showed a high risk of selection bias due to age mimicry, which could influence the distribution of age from each clavicular stage. Due to the limitations, we are unable to provide a reliable distribution of chronological age from each stage of medial clavicular development.