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Age determination by teeth, clavicle, and skeleton in the hand or wrist

According to the United Nations Convention on the Rights of the Child, everyone under the age of eighteen has extended rights. An asylum-seeker’s status as a minor may have a significant impact on his or her application for asylum in Sweden. When a person lacking legal documentation indicating their age applies for asylum in Sweden, age determination may be used to verify or refute the age-statement made by the asylum-seeker.

Medical age assessments are usually based on a thorough analysis of the individual’s medical history combined with height and weight measurements, and an assessment of maturity based on a physical examination. These measurements may be supplemented with radiological exams that estimate the degree of maturity of a person’s bones or teeth. Medical age assessment is regarded as controversial and ethically unacceptable by some medical professionals. In this response the SBU Enquiry Service focuses on a combination of three radiological methods for age assessment, maturity of the hand, teeth and clavicle.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Question

How reliable is age assessment using a combination of methods to determine skeletal maturity of the hand, teeth, and clavicle?

Literature search

Project group

Stephanie Juran and Jessica Dagerhamn at SBU. It has been reviewed inhouse by Sigurd Vitols and Jan Liliemark.

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