Costal Cartilage Calcification Research Articles

Estimation of age from digital chest radiographs in district Mandi, Himachal Pradesh

In forensic investigations estimation of age is a crucial part. Age estimation assists in narrow downing the search possibilities in the case of unidentified bodies and living individuals, it can also help in the determination of preparators and deciding the penalty for any criminal liability. Different body parts are often investigated at the crime scene, so estimating the age using different areas of the body is important. Hence, we conducted this study for age estimation from costal cartilage calcification. Only posterior-anterior (PA) digital chest radiographs are taken, and the first rib of the left side is evaluated. The degree of calcification and age showed a positive correlation; similarly, the value of Spearman’s rho showed significant results (for the whole sample =0.914, p < 0.01 (for male subjects was =0.925, p < 0.01. For females was =0.905, p < 0.01). The degree of calcification is useful in estimating age groups and becomes more determined with advancing age. Prediction of age using the radiological method gives the advantages of ease, inexpensiveness, rapidity, and high accuracy. In developing countries, this type of study will be very useful because infrastructure and lack of sources are major issues. The article provides a non-destructive method of age estimation in a forensic context that may act as a preliminary method of age estimation in mass disasters and dismembered bodies when a thoracic cage is only present.

ACCURACY OF PATIENTS AGE ASSESSMENT FROM FRONTAL CHEST RADIOGRAPHS

Background: Chest radiograph interpretation can be aided by knowing the patient'sage. Patients’ age is often assessed by radiologists from costal cartilage calcification assessment ofchest radiographs with anteroposterior views. Objectives: Therefore, we performed this research todetermine the precision of these radiologists in age estimation from CXRs. Methods: Ten radiologyexperts were selected to evaluate 3500 chest digital radiography with posterior-anterior images, inNational Institute of Child Health Karachi/JSMU from January 2022 to 2023. The most importantinclusion criteria were selecting normal or nearly normal radiographs in the study. Radiologists wereblind to patients actual age and were requested to determine patient’s age to closest decade from CXR.The respondents entered their responses in separate Excel spreadsheets. Results: A sum of 3,500CXRs was interpreted by radiologists, out of which 32.14% CXRs were correctly interpreteddetermining age at SD + 3 years, whereas 2375 CXRs were either overrated or underestimated(p<0.05) and misinterpreted the age of patients (2375/3500; 67.85%). Conclusion: Overall ageassessment from a frontal CXR was only 32.14% in our study; considerable disparities were identifiedin age estimation using CXRs. Yet, it would be fascinating to expand this academic endeavor throughartificial intelligence tools and possibly improving the precision of patient age prediction from CXR.This approach for determining the age will be useful for screening tests in the prospect.

Bilgisayarlı Tomografi Görüntüsünden Elde Edilen Kostokondral Kalsifikasyon Modeli ile Cinsiyet Tahmini

Background: Gender estimation plays a key role in human identification. Between the various meas-urement methods of gender estimation from skeletal remains, the use of the calcification patterns of costal cartilages is highly suggested especially when the skull and pelvic bones are not available. The purpose of this study is to determine the patterns of costal cartilage calcifications in the Turkish popula-tion and to predict gender accordingly.Materials and Methods: Our study was performed by using the Computed Tomography (CT) images of 200 individuals (100 female, 100 male) in the 20-60 age group who applied to Karabük University Train-ing and Research Hospital and had no costal pathology or surgery history. The classification of Rejta-rova et al. (2004) was used for the patterns of costal cartilage calcifications, and it was calculated the number and percentage of each pattern in male and female to estimate the gender.Results: The results showed 193 (96.5%) individuals with calcification in the costal cartilages and 7 (3.5%) individuals without calcification in their costal cartilages, which 3 females and 4 males. Peripher-al pattern (Type I) showed 100% male gender prediction, while central pattern (Type II) showed female gender prediction with 92.3%. Type III was the most common pattern with 66.8% in the Turkish popula-tion.Conclusions: As a result of this study, costal cartilage calcification models were obtained in the Turkish population using the method of Rejtarova et al (2004). Type I and Type II patterns showed high accuracy in terms of the usability of these models in predicting gender.

Evaluating costal cartilage for sex and age estimation from PA chest radiographs of North Indian population: a retrospective study

BackgroundThis study is conducted to estimate age and sex from chest radiographs. The aim of this study was to determine (I) whether costal cartilage calcification pattern help in estimating sex in North Indian sample and (ii) whether there is any relation between age and costal cartilage calcification.ResultsThe statistical probability of estimating peripheral pattern in male was 99.3%, and for females, it was 100% for central type of calcification. The minimum age where lower costal calcification was present was 22-year-old female and 21 years old male. The degree of calcification and age showed positive correlation; similarly, the value of spearman’s rho showed significant result (for whole sample rs = 0.911, p < 0.01 (for male subjects, it was rs = 0.921, p < 0.01; for females, it was rs = 0.905, p < 0.01)).ConclusionsThe degree of calcification is useful in estimating age groups and becomes more determined with advancing age. Prediction of sex by using radiological method gives the advantages of simplicity, inexpensiveness, speed, and high accuracy. This method for age and sex estimation will play a useful role in screening test and in cases where the thoracic part of the body is found like dismembered body, putrefied dead remains, and unidentified bodies.

Development of a nomogram for severe costal cartilage calcification: a cohort study.

There was few research on the causes or factors of costal cartilage calcification. Thus, this study aimed to develop a nomogram to predict the possibility of severe costal cartilage calcification. The cohort study included 882 patients who underwent computed tomographic (CT) scan of the chest with three-dimensional reconstructions and have completed the questionnaire between June 2020 to October 2021. The potential variables were included age, sex, body mass index (BMI), nation, residence, smoking, drinking, bedtime, exercise, self-pressure, the frequencies of milk, yogurt, carbonated drink, meat, fish, sea food, fruits intake, hypertension, diabetes, thyroid or parathyroid disease and osteoarthritis. We used the least absolute shrinkage and selection operator (LASSO) regression model to identify the optimal predictive features. Multivariable logistic regression analysis was used to build the predicting model. The receiver operating characteristic (ROC) curve and concordance index (C-index) were used to evaluate the accuracy of the nomogram. Moreover, decision curve analysis (DCA) was to estimate the clinical usefulness of the nomogram. Finally, we adopted internal validation of enhanced bootstrap adjustment for optimism to predict the C-index of the model. The predictive nomogram contained 11 clinical features using LASSO regression, and "Sex" and "Age" were the most important factor due to the most significant proportion. The model showed good discrimination with a C-index of 0.805, and the internal validation was 0.735. DCA (the threshold probability of a patient is 1-77%) and the ROC curve [the area under ROC (AUC) was 0.805, and the sensitivity and specificity were 0.647 and 0.894] demonstrated that the nomogram was possibly clinically helpful. This is the first study to develop a nomogram to predict severe costal cartilage. Use of this nomogram might help patients prevent calcification by changing living habits.

A GAN based approach for inferring progression trajectories of costal cartilage calcification from cross-sectional data at image level

BackgroundCostal cartilage calcification (CCC) increases with age and presents differently for men and women. In individuals, however, the cross-sectional studies that show such trends do not reveal the geometric trajectories through which calcification might accumulate across a lifetime. Generative adversarial networks have the potential to reveal such trajectories from cross-sectional data by learning population trends and synthesizing individualized images at progressive levels of calcification. MethodsChest wall mid-surface CT images with normalized cartilage morphologies were produced for 379 subjects aged 6 to 90, and labeled by sex and calcification severity. A conditional GAN with added loss terms to favor one-way accumulation of CCC was trained using organized image batches. GAN performance was assessed by comparing the distributions of images between the training and synthetic groups. ResultsSynthetic images generated from a common seed for a given sex and at successive calcification severity levels showed incremental and regional growth of calcification sites. CCC patterns for synthetic male and female images matched known sex-based differences, and individual CCC growth in synthetic images was consistent with previously observed population trends. These trends in the synthetic images were also quantified by structural similarity scores. Synthetic images generated from different input seeds further showed individual variance in specific regions and trajectories of CCC accumulation. ConclusionThis study inferred individual progression of CCC accumulation from uncalcified to severely calcified using cross-sectional image data. This information can inform computational models of the changing chest wall biomechanics with age, and the GAN-based technique shows potential for inferring longitudinal data from population trends in other clinical areas.

The diagnostic accuracy of hand-held ultrasonography in evaluation of costal cartilage calcification for grafting in rhinoplasty: A cadaveric study

Autologous costal cartilage graft (ACC) is considered a gold standard in complex rhinoplasty. Costal cartilage calcification remains a problematic issue, causing not only difficulties during the harvesting, carving, and fixation procedures but also worsening the long-term outcome with resorption. This study aims to establish diagnostic accuracy of hand-held ultrasonography in not only detecting the degree and pattern of costal cartilage calcification but also assessing its ability to predict the volume of the harvestable cartilage graft. The study was performed on 50 fresh cadavers with an age range between 17 and 80 years (mean 53.4±16.2 years). An ultrasonographic examination of the costal cartilage of 5th, 6th, and 7th ribs of both hemithoraces was performed. The presence of calcification of the cartilages and the pattern, length, width, cross-sectional area, and depth of calcification were observed and recorded. These results were compared against direct visualization and measurement via surgical dissection. Hand-held ultrasonography has a sensitivity of 94% and a specificity of 96% in detecting calcification with 96% positive predictive value and 93% negative predictive value. The positive likelihood ratio was 20.81 and the negative likelihood ratio was 0.06. Overall, the modality has demonstrated the ability to determine dimensions of the costal cartilage to within millimeters. The pattern of calcification was also correctly predicted in all 300 specimens. Hand-held ultrasonography is an affordable and accessible choice of demonstrating the presence and pattern of calcification as well as the general dimensions of the harvestable rib cartilage.

Possible Age and Sex Dependency of Costal Cartilage Calcification Degree Investigated by Computed Tomography: First Costal Cartilage Calcification is of Significance

Possible Age and Sex Dependency of Costal Cartilage Calcification Degree Investigated by Computed Tomography: First Costal Cartilage Calcification is of Significance

Association of Quantified Costal Cartilage Calcification and Long-Term Cumulative Blood Glucose Exposure: The Multi-Ethnic Study of Atherosclerosis.

AimsAnecdotal reports have suggested increased soft tissue calcification in individuals with long-term exposures to high blood glucose. The association of costal cartilage calcification (CCC), a reliably quantifiable marker obtainable from non-contrast cardiac computed tomography (CT) with cumulative fasting blood glucose (FBG) exposure, is unknown. In this study, we aimed to determine the association between quantified CCC and cumulative glucose exposure using non-contrast coronary artery calcium (CAC) scoring computed tomography (CT) images in the Multi-Ethnic Study of Atherosclerosis (MESA).MethodsThe volume of bilateral CCC was quantified in high-density pixels (threshold of Hounsfield Unit>180) using the CAC scoring CT images acquired in the 5th MESA exam. Prior long-term cumulative exposure to FBG was calculated by area under the FBG-time curve over ten years before the time of the CT exam.ResultsA total of 2,305 participants (mean age: 69, female/male: 1.3) were included in this study. The median CCC volume was lower in females than males (1158 mm3 [IQR: 1751] vs. 3054 mm3 [3851], p<0.001). In cross-sectional analysis, quantified CCC was associated with FBG (9% increase per SD) and HbA1c (7% increase per SD) at the CT exam only in female participants after adjustment for age, race, BMI, and glomerular filtration rate. Only in female participants, quantified CCC was also associated with prior cumulative FBG (3% increase per decile change). In the subgroup of females with zero CAC scores, the adjusted CCC was still associated with FBG (13% increase per SD) at the time of CT exam and with prior cumulative FBG exposure (4% increase per decile change) before the CT exam.ConclusionsThe CCC, a reliably quantified marker in non-contrast cardiac CT, is associated with 10-year cumulative FBG exposure only in female participants, even those with zero CAC.

Evaluation of manubriosternal joint fusion and second costal cartilage calcification: Are they useful for estimating advanced age groups?

The objectives of this study were to evaluate the manubriosternal joint (MSJ) to estimate the minimum chronological age of complete fusion, and how changes in this joint influence age estimation. The study also focused on investigating the calcification patterns of the second costal cartilage (SCC), as they may be related to age. Between January and September 2020, individuals between 30 and 80years of age, who underwent chest tomography at our institution, were listed by sex and divided into five groups according to age with intervals of 10years. Twenty patients from each age group and sex were randomly selected, and 200 patients were evaluated. The relationship between age and changes in MSJ and SCC was evaluated. The incidence of complete fusion did not differ significantly between the 30 and 80 age groups. A significant difference was found between the age groups and MSJ degeneration (p < 0.001). The degree of MSJ degeneration and calcification in SCC significantly increased with age, but the range was wide. These values might be used to support traditionally accepted age-estimation methods but not as independent indicators of specific age ranges.

Costal Cartilage Calcification: Prevalence, Amount, and Structural Pattern in the General Population and Its Association with Age: A Cadaveric Study.

Importance: Costal cartilage calcification (CCC) of the cartilage graft, commonly used in reconstruction of nasal/auricular deformities, can cause poor surgical outcome, but structural and quantitative analyses are lacking. Objective: To compare the prevalence, amount, and structural pattern of CCC from individuals by gender and age, as measured by digital contact radiography. Design, Setting, and Participants: This is a cross-sectional cadaveric study (n = 92) of the seventh rib cartilage. CCC prevalence/amount/structural pattern (central [c]/peripheral [p]/diffuse [d]) was analyzed within three age groups: I (<40 years), II (40-70 years), and III (>70 years). Main Outcomes and Measures: Qualitative and quantitative CCC analyses were set in relation to gender/structural pattern/age. Results: CCC prevalence was gender independent (96.7%) and occurred in c/p/d: 12.4%/22.4%/65.2%. Structural CCC pattern differed between age groups (I: 80%; c/p/d: 26.7%/46.6%/6.7%; II: 100%; c/p/d: 18.0%/30.8%/51.2%; III: 100%; p/d: 2.6%/97.4%). The mean CCC amount (9.1%) was gender independent and showed a significant correlation with age (p = 0.001). The mean amount showed a significant difference between the structural pattern [d/p: 3.3 times higher (p = 0.006), d/c: 7.7 times higher (p < 0.001)] and age groups (I/II/III: 6.4/8.5%/10.9%), whereby the amount was higher in groups II (factor: 7.4; p < 0.001) and III (factor: 16.5; p < 0.001) compared with group I. Conclusions: These data show an age-/gender-independent high CCC prevalence in the general population (96.7%). CCC already occurred in young donors (<40 years) with a not negligible amount (6.4%). CCC increased with age and structural analysis showed a gender-/age-specific pattern, whereby males were prone to peripheral/females to central CCC. Diffuse CCC was observed as an age-independent sign for high CCC levels.

Abstract 13595: Association of Costal Cartilage Calcification With Cardiovascular Events and Risk Factors in Multi-Ethnic Study of Atherosclerosis (MESA); The MESArthritis Study

Introduction: Costal cartilage calcification (CCC) is an evident yet usually neglected finding in calcium scoring CT scans. Although CAC score is a well-known predictive marker for CVD, little is known about the potential association between CCC and CVD risk factors (RFs) and events. Hypothesis: CCC is associated with CVD RFs and is predictive of CVD events independent from CAC score. Methods: Cardiac CAC score images from Johns Hopkins Hospital field center acquired within the fifth exam of the MESA cohort (2010-2012) were re-analyzed as part of the MESArthritis ancillary study. The CCC was measured bilaterally for the first pair of cartilages at the superior end of image FOVs using calcium scoring package (VScore, Vitrea 7.11, Vital Images) with a 180 HU cut-off. Outlier values were excluded using the IQR-based outlier fence estimates. Association of CCC with CVD RFs, and CVD and mortality time-to-event was investigated by multivariable linear regression and Cox proportional hazard models, respectively. Results: After exclusion of 3 outliers, 329 participants (53% female) with a mean age of 70.1 (±8.75) were included. In cross-sectional analysis, in addition to age (β=8.86, p:.003) and gender (376.0, p&lt;.001), CCC was associated with diabetes (141.42, p:.019) and glucose level (2.85, p:.006). CCC was correlated with Framingham global CVD risk score (FRS) (coefficient:0.39, p&lt;.001), but not with CAC when adjusted for age and gender. In time-to-event analysis, adjusted CCC was positively associated with CHD (HR:1.17, p:.039) and CVD (1.14, p:.012) risk. Compared with CAC score (C-index: 0.76) and FRS (0.74) individually, models with CCC addition to FRS (0.85) and both CAC and FRS (0.84) had higher C-index for CHD prediction. Conclusions: CCC is associated with diabetes and can be used to predict CHD and CVD events and augment the predictive power of the highly validated CAC and FRS for CHD events. However, this scoring should be validated in other larger cohorts.

Ultrasonographic evaluation of costal cartilage for microtia reconstruction surgery

PurposeAutogenous costal cartilage grafts have gained the golden standard method in microtia reconstruction. Right now, there was no useful method to assess the quality of costal cartilage before microtia reconstruction surgery. The purpose of this study was to evaluate the role of ultrasonography in assessing costal cartilage in patients who were ready to do microtia reconstruction surgery. MethodsA prospective controlled study was conducted to collect 65 patients who underwent microtia reconstruction and underwent ultrasonography of costal cartilage before operation. The results of costal cartilage calcification and honeycombed phenomenon measured by ultrasonography were compared with those during operation. The age-specific patterns in calcification and honeycombed phenomenon were explored. ResultsAccording to the results of ultrasonography, the positive rate of calcification was 10.9% in patients under 18 years old, while 80% in patients over 18 years old. The positive rate of honeycombed phenomenon was 2.8% in patients under 12 years old, 42.9% in patients between 12 and 18 years old, and 25% in patients over 18 years old. Compared with intraoperative results, the accuracy rate of ultrasonography for calcification was 100%. The accuracy rate for honeycombed phenomenon was 83.3%. ConclusionUltrasonography has high accuracy rate in assessing the calcification and honeycombed phenomenon of the costal cartilage, which was of vital importance for microtia reconstruction. The quality of costal cartilage changed with the age.

Prevelance of the costal cartilage fracture on the computerised tomography in chest trauma.

Radiography remains limited in costal cartilage injuries, and sonography, CT and MR imaging turns out to be more sensitive in the detection of cartilage injuries. This study aims to determine the frequency of costal cartilage fractures detected in the CT images of the patients with high energy chest trauma and to evaluate the association of costal cartilage fracture with the complications of trauma. The CT images of 93 patients aged 18-91years with a trauma admitted to the Emergency Department of the State Hospital between February 2019 and June 2019 were studied retrospectively. Thorax CT images of 93 patients who presented to the emergency department with blunt chest trauma with AIS > 2 were retrospectively investigated by a radiologist with a board certificate who had 15years of experience in the field. Costal cartilage fracture was identified in 39 of 93 patients with severe chest trauma. Among the 93 chest trauma patients admitted to the emergency department between February and June 2019, the prevalence of costal cartilage was calculated as 41.93%. Note that the most common costal cartilage fractures in the study group were identified in the 6th, 7th, 8th and 1st costal cartilages. Another significant relationship (p = 0.007) was found between costal cartilage calcification and cartilage fracture. Costal cartilage fractures frequently occur in blunt thoracic trauma with multiple rib fractures and are of clinical importance as they lead to the instability of chest wall. The incidence of cartilage fractures increases in elderly patients with costal cartilage calcification.

Characteristic of costal cartilages calcification in relation to sex and age: A forensic review in Aden population

In recent years, there has been renewed interest in forensic sciences about forensic age and sex estimation in living subjects by means of radiology. Costal cartilage bridges, the sternum and the ribs play a key role in the biomechanics of the chest, and is known to be calcified in local regions with age. This study aims at finding out the patterns of costal cartilage calcification in relation to sex and age, and was conducted on digital thorax X-rays to test the usefulness of some radiological changes in the costal cartilage. A descriptive cross sectional study of 1371 radiographs of chest plates were collected from a Diagnostic Medical Center (DMC) in Aden city / Yemen, during the period January 2017 to December 2018, all data were analyzed for their calcification patterns according to the methods of McCormick et al. The incidence of calcification increased with the advancement of age and the earliest appearance of calcification in costal cartilage was seen at 18-19 years in both sexes but more significantly in females. The tendency of central calcification of cartilage was displayed in females, while the peripheral calcification preferred in males, and the mixed calcification seen in both sexes but more in males. It is safe to conclude that different patterns of calcification at rib cartilage observed in digital radiographs are sex specific, that is to say male subjects predominantly show peripheral pattern and female subjects predominantly show central pattern. Calcification of costal cartilage starts at the age of 18-19 years in both sexes and increases with age.

Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging

To assess characteristics of Chinese costal cartilage and costa calcification using Dual-Energy computed tomography(DECT). 154 patients who underwent chest DECT scanning were included in our study. They were divided into following groups: less than 30 years old, 31–40 years old, 41–50 years old, 51–60 years old and over 60 years old. The sixth, seventh and eighth costal cartilages and costas were evaluated. Calcification patterns of cartilage were classified as central(C), peripheral(P), mixed(M) and no calcification(N) types. Calcification degree of cartilage was distinguished as 1(0–25%), 2(26–50%) and 3(>50%). CT value, calcium and water concentrations were measured in costal cartilage, cortical or cancellous bone respectively. An increasing C pattern of cartilage was displayed in females, while P type preferred in males as age increased. Calcification degree generally changed from 1 to 2 or 3 in females. CT value and calcium concentration of cartilage went through a gradual rising course and peaked in their 40–50 years, while those two indices of cancellous bone decreased gradually since their 50 years in females. The findings suggest a gradual calcification of the costal cartilage took place before 40–50 years old and a sharp bone loss of the costa happened after 40–50 years old in females.

Premature idiopathic costochondral calcification: A Case Report

Calcification of costal cartilage increases with age and it is rare before the age of thirty years. Early onset of costochondral calcification can be associated several endocrine and metabolic diseases, following a trauma, infections, malignancies or due to genetic factors and very rarely idiopathic. Our case exemplifies premature calcification of costal cartilages. The patient was a 20-year-old lady, referred to endocrine clinic in UMS polyclinic, Kingfisher, University Malaysia Sabah for evaluation of metabolic and endocrine causes of premature costochondral calcification. Physical examination findings were normal except mild tenderness over the left lower lateral part of the chest. Investigation results were inconclusive to detect any underlying endocrine, metabolic or inflammatory conditions. Chest X-Ray revealed bilateral calcification of the 10th, 11th and 12th costal cartilages and was diagnosed as idiopathic calcification of costal cartilage. Only analgesics were given as treatment and the pain subsided after few days.

Estimating Age at Death Based on Costal Cartilage Calcification.

Age estimation is a crucial part of forensic investigations. Because different parts of the body are often found at crime scenes, it is important to explore the regions that can be used for age estimation. Previous studies have used simple X-ray to analyze changes in costal cartilage calcification as a measure of age. Here, we tested whether age could be better estimated using measurements of costal cartilage calcification on postmortem CT images. In this study, male and female decedents (n = 10 each) from autopsy cases were grouped into 10-year incremental age groups (20-29 y; 30-39 y; up to 89 y). We found that the mean Hounsfield unit (CT number) and percentage calcification (the ratio of the ossified area to the whole area) increased with age for both sexes. However, there were marked individual differences within many of the groups, and this led to a statistically significant difference (P < 0.05) only between the 20-29 y group and the older age groups. To improve the ability to correctly assign cases to age groups, we introduced and reanalyzed the data using Bayesian statistics. This improved the classifications rates, with 40% of males and 35% of females correctly assigned into their age groups. Broadening the age range could further improve the number of matches. Thus, combining Bayesian statistics with CT imaging can be used to estimate age at death from costal cartilage calcification, and could be used as an adjunct in forensic investigations.

Türk İnsanında Birinci Kostal Kartilajın Kalsifikasyon Derecesi Temelinde Yaş Tayini

Objective: While developed countries do age estimation for the purpose of identification, in countries such as Turkey, it is used to determine the real age of a person with an already known identity because of inaccurate birth records. The aim of this article was to investigate whether the calcification degree of the first costal cartilage could be a marker for age determination. Material and Methods: We retrospectively analyzed the postero-anterior chest x-rays of 471 patients (270 males, 201 females; mean age ± standard deviation 42.38±20.69 years) who presented to the radiology department for various reasons. The calcification degree of the right first costal cartilage was classified in four stages based on criteria used by Barchilon and Garamendi, and the patients were classified in seven groups regarding their ages. The correlation between the calcification stage of the right first costal cartilages and age group was analyzed by Spearman's rho. Results: According to the first costal cartilage calcification stage, the mean ages were 5.56, 25.49, 45.39 and 66.02 at stage 0, 1, 2 and 3, respectively. The calcification degree of the right first costal cartilage and age correlated significantly in males and females [Spearman's rho=0.904, p<0.001 (0.924, p<0.001 in males and 0.864, p<0.001 in females)]. Conclusion: Although there are overlaps among age groups, the assessment of the calcification degree of the first costal cartilage on chest x-rays may be useful to predict the bone age. This age determination method can be used in criminal courts and forensic anthropology as a contributory technique.

Computational model of rib movement and its application in studying the effects of age-related thoracic cage calcification on respiratory system

A 3D finite element model of rib cage movement is developed and used to study the role of age-related costal cartilage and sternocostal joint calcification, as well as respiratory muscle weakness on the ‘bucket-handle’ movement of human rib. The volume displacement of the rib cage is related to changes in its circumference using an empirical equation presented by Agostoni et al. (1965, J Appl Physiol, 20:1179–1186). A systematic study is carried out to quantify the role of costal cartilage, sternocostal joint calcification and muscle weakness on the volume displacement of the rib cage. The results provide insight into some of the mechanisms underlying age-related changes in the respiratory system.