In the standard sequence of appearance of ossification centres at the elbow joint (mnemonic CRITOL), which centre appears LAST and is therefore a marker that the child has reached roughly 11 to 13 years of age?

• A Radial head
• B Olecranon process of the ulna
• C Trochlea of the humerus
• D Lateral epicondyle of the humerus ✓

Explanation

The CRITOL sequence is Capitulum, Radial head, Internal (medial) epicondyle, Trochlea, Olecranon, Lateral epicondyle. The lateral epicondylar centre appears last, at about 11 to 13 years, and its presence excludes an age below roughly 11 years. The radial head and trochlea appear earlier, around 5 and 9 to 10 years respectively, and the olecranon around 10 to 11 years. Elbow radiography is widely used in Indian medicolegal practice to assess ages near 16 years when combined with fusion status.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.