Standard for Epiphyseal Union in South African Children

Expert Profile

Dr. Kavita Lakha is currently working as Special Investigator and Forensic Anthropologist at National Prosecuting Authority (NPA) Johannesburg Area, South Africa. She has completed her B.Sc. and honors (specialized in Anatomy) at the University of Witwatersrand. She has received the Nelson Mandela Scholarship to do her Master’s Degree in forensic anthropology and Crime Scene Investigation at the University of Central Lancashire. She completed her Ph.D. in Human Biology at the University of Cape in 2016. She began working for the Missing Persons Task Team in 2009 and currently serves as the Forensic Anthropologist. The Missing Persons Task Team is responsible for locating and recovering the remains of individuals who have died during the human rights abuse of Apartheid in South Africa. She also has experience in ballistic trauma, explosive trauma, and juvenile age estimation.

Foreground

Forensic Anthropologist helps to determine if the skeletal remains obtained are human or not, in addition, they employ various methods to determine the gender, the age at death, race, and even the height of the deceased. In general, forensic anthropology uses the techniques of physical anthropology to analyze skeletal, badly decomposed or otherwise unidentified human remains to solve the crimes. Of the different variables, age at death is the key feature leading to identification in forensic anthropology. One of the factors used for age estimation in forensic anthropology is by using the method of epiphyseal union of bones. 

The lecture on the topic “Standards for Epiphyseal Union in South African Children” was delivered in the International Lecture Series by Dr. Kavita Lakha which incorporates with her Ph.D. work done in 2015. The presentation includes the standards which were invented by the speaker for the South African children to determine the chronological age on the basis of epiphyseal union, which is a widely accepted scientific method. Apart from this method, lengths of diaphysis and breadths of epiphysis are used for determining the age of the individual distinguishing between the ages from birth to 12 years.

Epiphyseal Union

Epiphyseal union is the ossification of the expanded end of the long bone which later gets fixed to the bone shaft when full growth is attained. Basically, in the epiphyseal union, the metaphysis of the bone fuses with the epiphysis (cap at the top of long bones). The epiphysis is composed of spongy cancellous bone which is further covered by a thin compact bone. This process of growth occurs at a specific age in an individual i.e. after the peak of the pubertal growth both in males and females. The epiphyseal union is controlled by the hormones secreted at puberty, estrogen in females and testosterone in males. As a result, females show epiphyseal growth (minimum of 1-2 years) in advance relative to males. 

Historical Studies in Epiphyseal Union

1. Greulich and Pyle (1929)

Greulich and Pyle developed a method to assess the chronological age of children. In this method, the radiographs of bones of hands and wrists of children of different ages which was then used as a reference (bone age atlas) to compare with the individual of unknown age. 

2. Tanner and Whitehouse (1975, 2001)

Tanner and Whitehouse developed another method similar to the Greulich and Pyle method which is also used to assess the chronological age of children. In this method, a scoring system is developed which is associated with each stage. The maturity level of each bone is categorized into different stages such as A, B,…, H, I. Thereafter, each stage is replaced by a score and the total score is transformed into the bone age.

Stages of Epiphyseal Union

The age determination is calculated based on the stages of the epiphyseal union. The four stages of the epiphyseal union include 1) Non-fusion 2) Partial fusion of less than 50% 3) Greater than 50% fusion 4) Complete fusion

• Stage 1: Non-fusion - In the non-fusion stage of epiphyseal union, it is observed that the diaphysis is separate from epiphysis due to the presence of a cartilaginous growth plate. Characteristics gap between diaphysis and epiphysis.

• Stage 2: Partial fusion of less than 50% - A radio-opaque thick line is observed between the epiphysis and diaphysis. In this stage, the diameter of epiphysis and diaphysis is the same in size and shape. 0% - 50% will be seen union at this stage. Also, Less than 50% of the adjacent ends are touching.

• Stage 3: Greater than 50% fusion - A continuous radiopaque thin line is observed which is also called a union scar. Over 50% of adjacent surfaces are in contact. Also, there is the presence of islands of cartilaginous ossification and increased continuity of shape between adjacent surfaces.

• Stage 4: Complete fusion - In this stage, the radiopaque thin line disappeared, also both the epiphysis and diaphysis is observed to be fused as one bone. 

Factors Affecting the Union of Epiphyseal

• Puberty: In females, the early secretion of estrogen results in the union of the epiphyseal which results in faster bone maturation.
• Socio-economic status: People with low socio-economic status result in malnutrition, thus delay in bone maturation whereas the people living with high socio-economic status will result in early bone maturation due to good nutrition.
• Malnutrition: Access to less food of lower quality and nutritional value will result in malnourishment.
• Chronic malnutrition: This will also result in stunting of children and delayed maturation.

Conclusion

Age estimation from bones is a very essential part of forensics to solve cold cases. The introduction of standards for the determination of age from bones in the South African population has become widely accepted. This standard can be applied for various forensic cases including rape and humanitarian forensic cases. 

Note: For detailed information and session recording, you can visit our YouTube Channel Forensic 365