To decide whether an unknown skeleton belonged to a person older than approximately 25 years, which epiphyseal site is examined, and why?

• A Distal end of femur, because it fuses last in the lower limb
• B Head of the radius, because it fuses at exactly 25 years in both sexes
• C Iliac crest, because its apophysis persists unfused throughout life
• D Medial (sternal) end of the clavicle, because it is the last epiphysis in the body to unite ✓

Explanation

The epiphysis at the sternal end of the clavicle unites at about 21 to 25 years and is the last in the entire skeleton to complete fusion, so a fused medial clavicular epiphysis places the individual beyond roughly 25 years. The distal femur fuses much earlier, around 16 to 19 years, and the iliac crest apophysis normally completes fusion in the early twenties, so neither can mark this final milestone.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 9th ed.

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