Background: Assessing the sternoclavicular joint is considered an important part of any forensic evaluation as far as age estimation is concerned. Age estimation of skeletal remains is based on the analysis of the degree of ossification of the medial clavicular epiphysis (MCO stage) using various imaging techniques (with TC considered the gold standard), the microscopic analysis of the degenerative morphological alterations of the medial clavicular surfaces, the histomorphometric analysis of the clavicular bone tissue and the quantitative microtomographic analysis of the trabecular bone microstructure of the medial clavicular bone. Study Aim: The current study aimed to examine the internal bone structure of the sternoclavicular joint via μ-TC imaging in order to identify changes in the trabecular and cortical microarchitecture linked to age allowing forensic specialists to use these values to estimate a subject’s age at death into three categories (younger than 40, 40-59, or older than 60). Materials and Methods: The sternoclavicular joints of only one side of 41 subjects divided into three age ranges at the time of death (<40 years, 40-59 years, ≥60 years) were examined using CTAn (CT-Analyser) software, and the most important histomorphometric parameters were calculated. Results: An analysis of the principle histomorphometric parameters of the clavicle and sternum bones identified a reduction in bone mineral density (BMD) of the sternum and clavicular spongal bones, bone volume fraction (BV/TV), connectivity (Conn) and structure thickness (St.Th) as age progressed. It likewise uncovered an increase in the specific bone surface for a given volume (BS/BV) and the spacing between the trabeculae (St.Sp) as age progressed. The degree of anisotrophy (DA) was not found to be statistically significant. There was an increase in the BS/BV and a reduction in the BV/TV and the St.Th of the cortical clavicle and sternum bones with age progression; but the BMD was not correlated with age progression. Discussion: The analysis of histomorphometric parameters primarily identified a correlation between age and both the clavicle and sternum bones, although the correlation was greater with regard to the latter. The sternal bone appeared to provide more accurate results with respect to the clavicle for classifying an individual into one of three age ranges. The accuracy was nevertheless even more evident when an integrated evaluation approach of the two bone structures was used. Study results thus confirmed the validity of the use of the μ-TC for estimating age for forensic purposes. They also underline the importance of microtomographic analysis of the sternum for estimating age, a new approach with respect to those used in the past, and they suggest that a diagnostic approach that analyzes the two bone surfaces both separately and, even more importantly, together should be taken.
Background: la valutazione dell’articolazione sterno-clavicolare riveste un ruolo fondamentale in antropologia forense, ai fini della stima dell’età, mediante l’analisi del grado di ossificazione dell’epifisi clavicolare mediale (MCO stage) attraverso varie tecniche di imaging (TC come Gold Standard), l’analisi macroscopica delle alterazioni morfologiche degenerative della superficie clavicolare mediale, l’analisi istomorfometrica del tessuto osseo clavicolare e l’analisi microtomografica quantitativa della microstruttura trabecolare dell’osso clavicolare mediale. Scopo dello studio: il presente studio si pone l’obiettivo di esaminare la struttura ossea interna dell’articolazione sterno-clavicolare tramite μ-TC al fine di identificare i cambiamenti della microarchitettura trabecolare e corticale in funzione dell’età, affinché tali cambiamenti possano essere utilizzati per ripartire il soggetto deceduto nelle tre categorie definite (età alla morte <40 anni, 40-59 anni, ≥60 anni). Materiali e metodi: sono state esaminate mediante μ-TC le articolazioni sterno-clavicolari di un solo lato di 41 soggetti suddivisi in 3 fasce sulla base dell’età alla morte (<40 anni, 40-59 anni, ≥60 anni), e mediante Software CTAn (CT-Analyser) sono stati calcolati i principali parametri istomorfometrici. Risultati: la valutazione dei principali parametri istomorfometrici ha evidenziato nella spongiosa sternale e clavicolare una diminuzione della densità minerale ossea (BMD), della frazione di volume osseo (BV/TV), della connettività (Conn) e dello spessore della spongiosa (St.Th), ed un aumento della superficie ossea per un dato volume (BS/BV) e dello spazio intertrabecolare (St.Sp) con l’avanzare dell’età; il grado di anisotropia (DA), invece, non ha mostrato alcuna significatività statistica. A livello corticale clavicolare e sternale si è evidenziato un aumento di BS/BV ed un decremento di BV/TV e St.Th con l’avanzare dell’età; BMD invece non ha mostrato alcuna correlazione con l’età. Discussione e conclusioni: la valutazione dei parametri istomorfometrici ha prevalentemente evidenziato una correlazione positiva con l’età per entrambi i capi articolari, maggiore nello sterno rispetto alla clavicola. Inoltre, la valutazione della struttura ossea sternale si è dimostrata più valida rispetto a quella clavicolare nel classificare l’individuo considerato nelle 3 fasce d’età definite; per di più, tale capacità discriminatoria è risultata più evidente quando veniva eseguita una valutazione integrata delle due strutture ossee. Con il presente studio si ribadisce quindi la validità della μ-TC ai fini della stima dell’età in ambito antropologico-forense, si sottolinea l’importanza dell’analisi microtomografica sternale ai fini della stima dell’età quale procedura mai eseguita prima, e si propone un approccio diagnostico che analizzi entrambe le superfici ossee in maniera sia separata che, ancor più, integrata.
Modificazioni età correlate della microarchitettura trabecolare dell’articolazione sterno-clavicolare a fini antropologico-forensi
BERGO, GIOVANNI
2022/2023
Abstract
Background: Assessing the sternoclavicular joint is considered an important part of any forensic evaluation as far as age estimation is concerned. Age estimation of skeletal remains is based on the analysis of the degree of ossification of the medial clavicular epiphysis (MCO stage) using various imaging techniques (with TC considered the gold standard), the microscopic analysis of the degenerative morphological alterations of the medial clavicular surfaces, the histomorphometric analysis of the clavicular bone tissue and the quantitative microtomographic analysis of the trabecular bone microstructure of the medial clavicular bone. Study Aim: The current study aimed to examine the internal bone structure of the sternoclavicular joint via μ-TC imaging in order to identify changes in the trabecular and cortical microarchitecture linked to age allowing forensic specialists to use these values to estimate a subject’s age at death into three categories (younger than 40, 40-59, or older than 60). Materials and Methods: The sternoclavicular joints of only one side of 41 subjects divided into three age ranges at the time of death (<40 years, 40-59 years, ≥60 years) were examined using CTAn (CT-Analyser) software, and the most important histomorphometric parameters were calculated. Results: An analysis of the principle histomorphometric parameters of the clavicle and sternum bones identified a reduction in bone mineral density (BMD) of the sternum and clavicular spongal bones, bone volume fraction (BV/TV), connectivity (Conn) and structure thickness (St.Th) as age progressed. It likewise uncovered an increase in the specific bone surface for a given volume (BS/BV) and the spacing between the trabeculae (St.Sp) as age progressed. The degree of anisotrophy (DA) was not found to be statistically significant. There was an increase in the BS/BV and a reduction in the BV/TV and the St.Th of the cortical clavicle and sternum bones with age progression; but the BMD was not correlated with age progression. Discussion: The analysis of histomorphometric parameters primarily identified a correlation between age and both the clavicle and sternum bones, although the correlation was greater with regard to the latter. The sternal bone appeared to provide more accurate results with respect to the clavicle for classifying an individual into one of three age ranges. The accuracy was nevertheless even more evident when an integrated evaluation approach of the two bone structures was used. Study results thus confirmed the validity of the use of the μ-TC for estimating age for forensic purposes. They also underline the importance of microtomographic analysis of the sternum for estimating age, a new approach with respect to those used in the past, and they suggest that a diagnostic approach that analyzes the two bone surfaces both separately and, even more importantly, together should be taken.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/48115