Age Estimation Based on a Radiographic Study of the Growing Foot

by MASS4D® Prescription Orthotics May 01, 2017

The authors sought to determine a predictive model of data, differentiated by gender, from a radiographic study of the skeleton of the foot as an alternative to the classic study of the hand.

The study included 2,476 digital radiographs from 816 individuals aged 0 to 21 years; these radiographs were weightbearing lateral, weightbearing dorsoplantar, and oblique images of right and left feet.

Image analysis was performed following the system validated by Whitaker et al. designed to estimate the age in months from the skeletal radiograph of the foot.

It consists of applying graded scales of stages of ossification of each of the growing foot bones; the system has three independent scales applicable to each foot bone, always given that the foot is in the process of maturation.

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Each foot bone is assigned three numbers: grading of the primary centre, grading of the secondary centre, and the degree of fusion.

The radiographs were visualised and analysed by four qualified examiners (podiatric physicians and radiologists) at different intervals.

The authors established that for females, the determination of the bone data

can be estimated with minimal bias from the following bones: the fusion of the fifth metatarsal, the secondary ossification centre of the fourth metatarsal, the cuboid in its maximum degree of maturation, the fusion of the proximal phalanx of the fifth toe, and the fusion of the proximal phalanx of the great toe.

The following bones best predict age for males: the fusion of the fifth metatarsal, the primary centre of the scaphoid, the peroneal sesamoid, the primary ossification centre of the middle phalanx of the third toe, the secondary ossification centre of the distal phalanx of the second toe, the fusion of the proximal phalanx of the great toe, and the fusion of the proximal phalanx of the second toe.

The foot can be considered as a good predictor of an individual’s age from birth to complete bone maturity.

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References:

1. Gomez-Martin, B., Escamilla-Martinez, E., Fernandez-Seguin, L. M., Santiago-Saez, A., Sanchez-Sanchez, J. A., Diaz-Mancha, J. A. (2017) Age Estimation Based on a Radiographic Study of the Growing Foot. Journal of the American Podiatric Medical Association: March/April 2017, Vol. 107, No. 2, pp. 106-111.

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