Forensic age estimation using knee MRI: application of the Vieth staging system in a French population.

Cohort studyInternational journal of legal medicine· Jul 2026

Forensic age estimation using knee MRI: application of the Vieth staging system in a French population.

Oguzhan Ekizoglu, Quentin Rebillard, Sophie Colomb … Laurent Martrille

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Musculoskeletal ImagingCohort studyQ1IF 3.1

Knee magnetic resonance imaging ossification stage closely tracks chronological age in ages 9-30.

Forensic age estimation using knee MRI: application of the Vieth staging system in a French population.

Oguzhan Ekizoglu … Laurent Martrille

International journal of legal medicine · Jul 2026

Background

Forensic age assessment is a critical process in determining an individual's legal status, particularly in the evaluation of the 18-year threshold, where reliable methods are essential.

Methods

A total of 512 knee magnetic resonance imaging examinations (280 males, 232 females; age range 9-30 years) were retrospectively evaluated.

n = 512 knee MRI examinations

Results

r ≈ 0.88

Magnetic resonance imaging ossification stage tracked chronological age closely, higher stage matching older age

n = 512 knee MRI examinations

More results

Intraobserver agreement was almost perfect (κ = 0.99), and interobserver agreement was very good (κ = 0.81-0.87).

No significant sex-related differences were identified across stages.

The minimum age for complete fusion (stage 6) was 21.13 years in males and 20.74 years in females for the distal femur, and 19.92 and 17.69 years for the proximal tibia, respectively.

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Conclusion

Further validation through studies involving diverse populations and varied magnetic resonance imaging protocols is expected to enhance its standardization and strengthen its role in forensic decision-making.

Forensic age estimation using knee MRI: application of the Vieth staging system in a French population.

Forensic age estimation using knee MRI: application of the Vieth staging system in a French population.

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