The application of McKern-Stewart's method for age estimation using Computed Tomography imaging of the pubic symphysis of living individuals

Abstract

• CT examination of pubic symphysis is a newer tool to aid age estimation in the living • CT allows visualization of pubic symphysis in living • Mckern-Stewart's method is a well-established age estimation technique • Age estimation in the living using the Mckern-Stewart method has not been done before in India Many studies have been conducted to study age-related changes in human pubic symphyseal surfaces but no recorded study was found on living persons using Mckern-Stewart (1957) method. Mckern-Stewart's method applies phase scoring for the three components of the pubic symphysis, and thus introduces objectivity to the otherwise subjective and somewhat confusing avenue of age estimation. This prospective cross-sectional study analysed age-related changes of pubic symphyseal surfaces in 3-D reconstructed CT images of the symphyseal surface by application of the Mckern-Stewart method in living individuals. It was carried out on 123 participants in a known age group of 15 to 60 years in the S.M.S. Medical College, Jaipur, (Rajasthan, India). The 3D reconstructed CT images of the symphyseal surface were evaluated for all the three components of Mckern-Stewart method. The subjects were categorized into eight age groups at five year intervals. We observed that the score as per Mckern-Stewart method was linearly proportionate to the age of the individual participant. Age and Mckern-Stewart's score was found to be significantly correlated for both the sexes. Regression models were generated to estimate age from the total Mckern-Stewart's score. In conclusion, we found out that age can be estimated by application of Mckern-Stewart method, when applied to 3D reconstructed CT images of pubic bones in living individuals. Mckern-Stewart's method is especially helpful for estimating age for individuals in the 15 to 40 years old age range.