Evaluation of the suitability of the Greulich and Pyle atlas in estimating age for the Botswana population using hand and wrist radiographs of young Botswana population

The applicability of Greulich and Pyle atlas for estimating age for court cases that require age estimation amongst the Botswana population is often questioned because the atlas has been adopted without being evaluated for Botswana. It has long been established that accuracies of such age estimation methods are dependent on different factors such as the general health and nutrition of the population. We present a study aimed at determining the level of accuracy of the Greulich and Pyle atlas at estimating age for the Botswana population. It is the first time that this type of study is being performed for Botswana. The results will be used to confirm if there is need to develop specific age estimation standards for Botswana. A total of 140 x-ray image samples were obtained from local hospitals for patients aged between 5 and 18 years. The sample images were compared with the Greulich and Pyle age estimation standards. In forensic age estimations, there are several important age limits which are considered. The legal age of maturity for Botswana is 18 years. This age limit is very important in determining whether offenders should be tried as children or adults and at the same time, in determining if victims are minors or adults. It also forms the basis for sentencing of offenders for crimes committed against children. For the important age group 15 ≤ 18 the mean skeletal age difference was found to be 0.94 (statistically significant) indicating that age was underestimated for males. This could be a problem where a perpetrator’s age is underestimated as a result not sentenced accordingly as they are mistaken for a minor. The mean skeletal age difference for females was found to be 0.64 years, indicating that age was underestimated by up to 0.64 years for females while the mean skeletal age difference was found to be 0.50 years for males in overall. This indicated that the Greulich and Pyle atlas underestimated age by 0.50 years overall. Significant statistical difference was observed between the mean chronological age and the mean estimated age as the p-values were found to be 0.03 for females and 0.05 for males. Based on these findings, it can be concluded that the Greulich and Pyle atlas can be used to estimate age but with caution as there is a possibility of errors. There is need for this atlas to be revised to reduce errors in age estimation for the Botswana context.