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Age Estimation Based on a Radiographic Study of the Growing Foot

Beatriz Gómez-Martín Department of Nursing, University of Extremadura, Plasencia, Spain.

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Elena Escamilla-Martínez Department of Nursing, University of Extremadura, Plasencia, Spain.

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Lourdes María Fernández-Seguín Department of Physiotherapy, University of Seville, Seville, Spain.

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Andrés Santiago-Sáez Department of Toxicology, University Complutense of Madrid, Madrid, Spain.

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José Antonio Sánchez-Sánchez Department of Toxicology, University Complutense of Madrid, Madrid, Spain.

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Juan Antonio Díaz-Mancha Department of Physiotherapy, University of Seville, Seville, Spain.

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Background:

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

Methods:

The study included 2,476 digital radiographs from 816 participants aged 0 to 21 years. The radiographs were from the Radiology Diagnostic Services of the Public Health System of Extremadura (Spain) from 2007 to 2011. The method used for their analysis consisted of assigning a numerical code to each ossification center of each growing bone of the foot and subsequently subjecting the data to a multivariate, decision tree, statistical analysis.

Results:

The decision tree study identified the bones that have a common age-dependent pattern of growth (as determined by a comparison of means test with P < .01) among individuals of the same sex. The quality of the decision tree predictions was evaluated in terms of the r coefficient. These values were r 2 = 0.897 for females and r 2 = 0.890 for males, thus establishing the predictive goodness of the model of bone data to provide a specific estimate of the individual's age.

Conclusions:

The foot is a good predictor of an individual's age from birth to complete bone maturity.

Corresponding author: Beatriz Gómez-Martín, MD, Department of Nursing, University of Extremadura, Avd. Virgen del Puerto n° 2, Plasencia, Cáceres 10600, Spain. (E-mail: bgm@unex.es)