The epiphyseal scar: changing perceptions in relation to skeletal age estimation.

BACKGROUND: It is imperative that all methods applied in skeletal age estimation and the criteria on which they are based have a strong evidential basis. The relationship between the persistence of epiphyseal scars and chronological age, however, has remained largely untested. AIMS: To assess the relationships between the level of persistence of the epiphyseal scar and chronological age, biological sex and side of the body in relation to the interpretation of epiphyseal scars in methods of skeletal age estimation. SUBJECTS AND METHODS: A sample of radiographic images was obtained from the Tayside NHS Trust, Ninewells Hospital, Dundee, UK. This included images of four anatomical regions from living female and male individuals aged between 20-50 years. RESULTS: Some remnant of an epiphyseal scar was found in 78-99% of individuals examined in this study. The level of persistence of epiphyseal scars was also found to vary between anatomical regions. CONCLUSION: The overall relationship between chronological age and the level of persistence or obliteration of the epiphyseal scar was found to be of insufficient strength to support a causative link. It is, therefore, necessary that caution is employed in their interpretation in relation to skeletal age estimation practices.