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Farooq M, Belair JA, Desai V. Pediatric Shoulder Girdle. Semin Musculoskelet Radiol 2024; 28:384-395. [PMID: 39074722 DOI: 10.1055/s-0044-1779717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
The pediatric shoulder girdle is a complex anatomical structure uniting the upper extremity and trunk. The osseous structures, their articulations, and the surrounding soft tissue support structures (muscles, tendons, and ligaments) allow for a wide range of motion at the shoulder. Growth and maturation of the components at the shoulder girdle vary, particularly the osseous structures. This characteristic renders interpretation of imaging of the pediatric shoulder girdle more challenging because normal or variant anatomy can be confused for pathology. We review the physiologic growth and maturation of the shoulder girdle with special emphasis on the development of the bones and their articulations. The role of various imaging modalities and the common osseous and soft tissue variants in the pediatric shoulder are also discussed.
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Affiliation(s)
- Mobeen Farooq
- Department of Radiology, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Jeffrey A Belair
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vishal Desai
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Oh S, Kumagai A, Kim SY, Lee SS. Accuracy of age estimation and assessment of the 18-year threshold based on second and third molar maturity in Koreans and Japanese. PLoS One 2022; 17:e0271247. [PMID: 35802665 PMCID: PMC9269881 DOI: 10.1371/journal.pone.0271247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022] Open
Abstract
This study aimed to validate Lee’s age estimation method and assess the 18-year threshold in Korean and Japanese populations. We evaluated the maxillary and mandibular second (M2) and third molars (M3) in 2657 orthopantomograms of the Korean and Japanese populations aged 15–23 years (19.47±2.62 years for Koreans, 19.31±2.60 years for Japanese), using Demirjian’s criteria. Dental age was estimated, and correlations between chronological and dental ages were analyzed. Classification performance was calculated based on the 18-year threshold. The relationship between developmental stage and chronologic age was analyzed using multiple linear regression. Our results revealed that Lee’s method was appropriate for estimation in the Korean population. When the Lee’s method was applied to the Japanese population, a lower value of correlation coefficients between estimated and chronological age, and lower specificity were observed. Population differences were observed predominantly in the stages of root development (stages F and G) of M2s and M3s in both jaws and more frequently in females than in males. In the multiple linear regression between developmental stage and chronological age, lower values of adjusted r2 were observed in the Japanese population than in the Koreans. In conclusion, the Lee’s method derived from the Korean population data might be unsuitable for Japanese juveniles and adolescents. To support the findings of this study, future studies with samples from multiple institutions should be conducted. Future studies with larger sample sizes are also warranted to improve the accuracy of dental age estimation and confirm the developmental pattern of teeth in the Japanese population.
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Affiliation(s)
- Sehyun Oh
- Department of Anatomy Catholic Institute of Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Akiko Kumagai
- Division of Forensic Odontology and Disaster Oral Medicine, Department of Forensic Science, Iwate Medical University, Morioka, Iwate, Japan
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Seob Lee
- Department of Anatomy Catholic Institute of Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
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Radiology "forensics": determination of age and sex from chest radiographs using deep learning. Emerg Radiol 2021; 28:949-954. [PMID: 34089126 DOI: 10.1007/s10140-021-01953-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/24/2021] [Indexed: 01/23/2023]
Abstract
PURPOSE To develop and test the performance of deep convolutional neural networks (DCNNs) for automated classification of age and sex on chest radiographs (CXR). METHODS We obtained 112,120 frontal CXRs from the NIH ChestX-ray14 database performed in 48,780 females (44%) and 63,340 males (56%) ranging from 1 to 95 years old. The dataset was split into training (70%), validation (10%), and test (20%) datasets, and used to fine-tune ResNet-18 DCNNs pretrained on ImageNet for (1) determination of sex (using entire dataset and only pediatric CXRs); (2) determination of age < 18 years old or ≥ 18 years old (using entire dataset); and (3) determination of age < 11 years old or 11-18 years old (using only pediatric CXRs). External testing was performed on 662 CXRs from China. Area under the receiver operating characteristic curve (AUC) was used to evaluate DCNN test performance. RESULTS DCNNs trained to determine sex on the entire dataset and pediatric CXRs only had AUCs of 1.0 and 0.91, respectively (p < 0.0001). DCNNs trained to determine age < or ≥ 18 years old and < 11 vs. 11-18 years old had AUCs of 0.99 and 0.96 (p < 0.0001), respectively. External testing showed AUC of 0.98 for sex (p = 0.01) and 0.91 for determining age < or ≥ 18 years old (p < 0.001). CONCLUSION DCNNs can accurately predict sex from CXRs and distinguish between adult and pediatric patients in both American and Chinese populations. The ability to glean demographic information from CXRs may aid forensic investigations, as well as help identify novel anatomic landmarks for sex and age.
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Pham CV, Lee SJ, Kim SY, Lee S, Kim SH, Kim HS. Age estimation based on 3D post-mortem computed tomography images of mandible and femur using convolutional neural networks. PLoS One 2021; 16:e0251388. [PMID: 33979376 PMCID: PMC8115850 DOI: 10.1371/journal.pone.0251388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Age assessment has attracted increasing attention in the field of forensics. However, most existing works are laborious and requires domain-specific knowledge. Modern computing power makes it is possible to leverage massive amounts of data to produce more reliable results. Therefore, it is logical to use automated age estimation approaches to handle large datasets. In this study, a fully automated age prediction approach was proposed by assessing 3D mandible and femur scans using deep learning. A total of 814 post-mortem computed tomography scans from 619 men and 195 women, within the age range of 20-70, were collected from the National Forensic Service in South Korea. Multiple preprocessing steps were applied for each scan to normalize the image and perform intensity correction to create 3D voxels that represent these parts accurately. The accuracy of the proposed method was evaluated by 10-fold cross-validation. The initial cross-validation results illustrated the potential of the proposed method as it achieved a mean absolute error of 5.15 years with a concordance correlation coefficient of 0.80. The proposed approach is likely to be faster and potentially more reliable, which could be used for age assessment in the future.
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Affiliation(s)
- Cuong Van Pham
- Department of Electronics and Computer Engineering, Chonnam National University, Gwangju, South Korea
| | - Su-Jin Lee
- Department of Forensic Medicine, Chonnam National University, Gwangju, South Korea
| | - So-Yeon Kim
- Department of Forensic Medicine, Chonnam National University, Gwangju, South Korea
| | - Sookyoung Lee
- Department of Forensic Medicine, Chonnam National University, Gwangju, South Korea
- Department of Forensic Medicine, National Forensic Service, Gangwondo, South Korea
| | - Soo-Hyung Kim
- Department of Artificial Intelligence Convergence, Chonnam National University, Gwangju, South Korea
| | - Hyung-Seok Kim
- Department of Forensic Medicine, Chonnam National University, Gwangju, South Korea
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Kim HHR, Ngo AV, Maloney E, Otjen JP, Iyer RS, Menashe SJ, Thapa M. Contemporary imaging of the pediatric shoulder: pearls and pitfalls. Pediatr Radiol 2021; 51:338-352. [PMID: 33544190 DOI: 10.1007/s00247-021-04963-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/13/2020] [Accepted: 01/05/2021] [Indexed: 01/17/2023]
Abstract
In skeletally immature patients, the presence of growth plates and articular cartilage of the shoulder can create a predisposition for unique injuries not observed in adults. Furthermore, increasing participation in sports by children and adolescents appears to be leading to a corresponding increase in the number of sports-related injuries. The importance of radiologists being familiar with pediatric shoulder imaging and its associated injuries is therefore growing. In this article, we review the normal development and maturation pattern of ossification centers of the shoulder from the early gestational period through adolescence. Brachial plexus birth palsy, physeal injuries, shoulder dislocation, and internal impingement are discussed within the context of the child's age and the mechanism of injury to guide radiologists to a correct diagnosis.
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Affiliation(s)
- Helen H R Kim
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA.
| | - Anh-Vu Ngo
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Ezekiel Maloney
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Jeffrey P Otjen
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Ramesh S Iyer
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Sarah J Menashe
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Mahesh Thapa
- Department of Radiology, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
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Age estimation in the living: A scoping review of population data for skeletal and dental methods. Forensic Sci Int 2021; 320:110689. [PMID: 33561788 DOI: 10.1016/j.forsciint.2021.110689] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
Age estimation of living individuals has become a crucial part of the forensic practice, especially due to the global increase in cross-border migration. The low rate of birth registration in many countries, hence of identification documents of migrants, especially in Africa and Asia, highlights the importance of reliable methods for age estimation of living individuals. Despite the fact that a number of skeletal and dental methods for age estimation have been developed, their main limitation is that they are based on specific reference samples and there is still no consensus among researchers on whether these methods can be applied to all populations. Though this issue remains still unsolved, population information at a glance could be useful for forensic practitioners dealing with such issues. This study aims at presenting a scoping review and mapping of the current situation concerning population data for skeletal (hand-wrist and clavicle) and dental methods (teeth eruption and third molar formation) for age estimation in the living. Two hundred studies on the rate of skeletal maturation and four hundred thirty-nine on the rate of dental maturation were found, covering the period from 1952 and 2020 for a total of ninety-eight countries. For most of the western and central African countries there are currently no data on the rate of skeletal and dental maturation. The same applies to the countries of the Middle East, as well as the eastern European countries, especially as regard the skeletal development.
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Evaluation of using scoring systems of epiphyseal union at knee joint to assess chronological age among a sample of Egyptians. Leg Med (Tokyo) 2019; 39:15-24. [PMID: 31170617 DOI: 10.1016/j.legalmed.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/19/2019] [Accepted: 05/25/2019] [Indexed: 11/22/2022]
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Anatomic shape variants of extremitas sternalis claviculae as collected from sternoclavicular thin-slice CT-studies of 2820 male borderline-adults. Int J Legal Med 2019; 133:1517-1528. [PMID: 31104134 DOI: 10.1007/s00414-019-02065-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
Abstract
Within medical age assessment practice, the indicator "medial clavicular ossification" constitutes crucial evidence capable of excluding age minority "beyond reasonable doubt" concerning age-disputed individuals doubtfully claiming children's rights during legal procedures. Yet, one of its characteristics affects the morphological variability including a fair amount of downright peculiar appearances. As a result, inexperienced examiners are tempted to classify actually not-assessable formations according to the two established developmental typologies of Schmeling et al. and Kellinghaus et al. being at the same time the most frequent systemic error of age-related clavicular taxation. Since a respective overview appears missing, the study extracts not-assessable shape variants of the medial collar bone from a large sample of 2820 male borderline-adults as seen from thin-slice, sternoclavicular computed tomography. The two already highlighted configurations "more than one, medial, secondary ossification centres" and "medial metaphyseal concavity" are found as the most commonly encountered features impeding reliable delineation of staging criteria. In accordance with previous literature, it is emphasized that "qualified" rating of extremitas sternalis claviculae within age assessment practice presupposes "knowledge about the diversity of [its] anatomic shape variants."
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