Accuracy of Age Estimation from Right Fourth Rib in Male Libyan Population

Abstract

Age estimation is an important component of forensic identification, particularly in unidentified skeletal remains and living individuals of undocumented age. The sternal end of the right fourth rib has been widely used for adult age estimation because it undergoes progressive age-related morphological changes involving pit depth and shape, rim configuration, wall thickness, and bone quality. This review summarizes the anatomical basis of fourth-rib age estimation, the İşcan and Loth morphological methods, factors affecting their accuracy, and the influence of population variation, with relevance to validation in the male Libyan population. It also reviews the application of computed tomography and three-dimensional reconstruction for assessment of the sternal rib end. Previous studies have demonstrated good intra-observer and inter-observer reliability for fourth-rib assessment; however, accuracy may vary according to age group, sex, and population, supporting the importance of population-specific validation, particularly in male populations. Studies using multislice and post-mortem CT have shown good agreement with direct skeletal assessment, supporting the use of virtual evaluation of fourth-rib morphology. Population-specific validation remains important because established standards may underestimate or overestimate age when applied to different populations, including male populations from different geographic and ethnic backgrounds. Conclusion: Three-dimensional CT assessment of the sternal end of the right fourth rib is a reliable and valid method for age estimation, showing good comparability with direct skeletal assessment. Its non-invasive nature also supports its application in living individuals.